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. 2018 Sep 24;32(15):2113-2118.
doi: 10.1097/QAD.0000000000001948.

HIV DNA levels and decay in a cohort of 111 long-term virally suppressed patients

Jonathan L Golob  1   2 , Joshua Stern  3 , Sarah Holte  3 , Mari M Kitahata  1 , Heidi M Crane  1   4 , Robert W Coombs  1   5 , Erin Goecker  5 , Ann E Woolfrey  6 , Robert D Harrington  1
Affiliations

HIV DNA levels and decay in a cohort of 111 long-term virally suppressed patients

Jonathan L Golob et al. AIDS. .

Abstract

Background and method: We examined specimens from 111 HIV-infected participants virally suppressed on ART for a minimum of 5 years who had donated serial peripheral blood mononuclear cell (PBMC) specimens to the University of Washington/Fred Hutch Center for AIDS Research (CFAR) Specimen Repository. We determined the HIV proviral copy number per million PBMCs, corrected for CD4 cell count, in 477 specimens collected after a minimum of 5 years of follow-up and up to 15.5 years of clinical viral suppression. Generalized estimating equation regression was used to examine the association between the reservoir size and time, age at study entry, antiretroviral regimen, and risk factors for HIV acquisition.

Results and conclusion: We found that the inter-participant baseline HIV DNA level varied widely between 0.01 and 4.8 pol-copies per microgram genomic DNA and per CD4 cell number/micoliter; the HIV DNA level declined with time (half-life was estimated at 12 years, 95% confidence interval of 6.2-240 years); the HIV DNA level was lower for those who achieved viral suppression at a younger age; and the HIV DNA level was not affected by the specific antiretroviral regimen used to achieve and maintain suppression.

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Conflict of interest statement

Conflicts of Interest:

The authors have no conflicts of interest to disclose.

Figures

Figure 1:
Figure 1:. HIV DNA size as determined by quantitative PCR against the HIV gag or pol gene.
Each circle represents one sample. The x-axis is the reservoir size as determined by gag qPCR, the y-axis as determined by pol qPCR. There were 68 samples for which the pol gene amplified by the gag gene did not.
Figure 2:
Figure 2:. Change in HIV DNA over time.
Each grey line represents one participant’s reservoir size over time. The x-axis is time in years starting from the individual’s first sample. The y-axis represents reservoir size as estimated by qPCR for the HIV pol gene, normalized to total genomic DNA (gDNA) and then absolute CD4 count (cells per mm3), finally log transformed (base 10). The solid black line is the corrected decay rate as estimated by our linear mixed effect model, with dashed black lines for the estimated 95% confidence interval of the decay rate.
See this image and copyright information in PMC

Comment in

References

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