Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.

<h4>Background</h4>Limited knowledge exists on early HIV events that may inform preventive and therapeutic strategies. This study aims to characterize the earliest immunologic and virologic HIV events following infection and investigates the usage of a novel therapeutic strategy.<h4&g...

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Main Authors: Jintanat Ananworanich, Alexandra Schuetz, Claire Vandergeeten, Irini Sereti, Mark de Souza, Rungsun Rerknimitr, Robin Dewar, Mary Marovich, Frits van Griensven, Rafick Sekaly, Suteeraporn Pinyakorn, Nittaya Phanuphak, Rapee Trichavaroj, Wiriya Rutvisuttinunt, Nitiya Chomchey, Robert Paris, Sheila Peel, Victor Valcour, Frank Maldarelli, Nicolas Chomont, Nelson Michael, Praphan Phanuphak, Jerome H Kim, RV254/SEARCH 010 Study Group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0033948&type=printable
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author Jintanat Ananworanich
Alexandra Schuetz
Claire Vandergeeten
Irini Sereti
Mark de Souza
Rungsun Rerknimitr
Robin Dewar
Mary Marovich
Frits van Griensven
Rafick Sekaly
Suteeraporn Pinyakorn
Nittaya Phanuphak
Rapee Trichavaroj
Wiriya Rutvisuttinunt
Nitiya Chomchey
Robert Paris
Sheila Peel
Victor Valcour
Frank Maldarelli
Nicolas Chomont
Nelson Michael
Praphan Phanuphak
Jerome H Kim
RV254/SEARCH 010 Study Group
author_facet Jintanat Ananworanich
Alexandra Schuetz
Claire Vandergeeten
Irini Sereti
Mark de Souza
Rungsun Rerknimitr
Robin Dewar
Mary Marovich
Frits van Griensven
Rafick Sekaly
Suteeraporn Pinyakorn
Nittaya Phanuphak
Rapee Trichavaroj
Wiriya Rutvisuttinunt
Nitiya Chomchey
Robert Paris
Sheila Peel
Victor Valcour
Frank Maldarelli
Nicolas Chomont
Nelson Michael
Praphan Phanuphak
Jerome H Kim
RV254/SEARCH 010 Study Group
author_sort Jintanat Ananworanich
collection DOAJ
description <h4>Background</h4>Limited knowledge exists on early HIV events that may inform preventive and therapeutic strategies. This study aims to characterize the earliest immunologic and virologic HIV events following infection and investigates the usage of a novel therapeutic strategy.<h4>Methods and findings</h4>We prospectively screened 24,430 subjects in Bangkok and identified 40 AHI individuals. Thirty Thais were enrolled (8 Fiebig I, 5 Fiebig II, 15 Fiebig III, 2 Fiebig IV) of whom 15 completed 24 weeks of megaHAART (tenofovir/emtricitabine/efavirenz/raltegravir/maraviroc). Sigmoid biopsies were completed in 24/30 at baseline and 13/15 at week 24. At baseline, the median age was 29 years and 83% were MSM. Most were symptomatic (87%), and were infected with R5-tropic (77%) CRF01_AE (70%). Median CD4 was 406 cells/mm(3). HIV RNA was 5.5 log(10) copies/ml. Median total blood HIV DNA was higher in Fiebig III (550 copy/10(6) PBMC) vs. Fiebig I (8 copy/10(6) PBMC) (p = 0.01) while the median %CD4+CCR5+ gut T cells was lower in Fiebig III (19%) vs. Fiebig I (59%) (p = 0.0008). After 24 weeks of megaHAART, HIV RNA levels of <50 copies were achieved in 14/15 in blood and 13/13 in gut. Total blood HIV DNA at week 0 predicted reservoir size at week 24 (p<0.001). Total HIV DNA declined significantly and was undetectable in 3 of 15 in blood and 3 of 7 in gut. Frequency of CD4+CCR5+ gut T cells increased from 41% at baseline to 64% at week 24 (p>0.050); subjects with less than 40% at baseline had a significant increase in CD4+CCR5+ T cells from baseline to week 24 (14% vs. 71%, p = 0.02).<h4>Conclusions</h4>Gut T cell depletion and HIV reservoir seeding increases with progression of AHI. MegaHAART was associated with immune restoration and reduced reservoir size. Our findings could inform research on strategies to achieve HIV drug-free remission.
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spelling doaj-art-c49702a6e259441ea7e70755a0451c1e2025-08-20T03:09:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0173e3394810.1371/journal.pone.0033948Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.Jintanat AnanworanichAlexandra SchuetzClaire VandergeetenIrini SeretiMark de SouzaRungsun RerknimitrRobin DewarMary MarovichFrits van GriensvenRafick SekalySuteeraporn PinyakornNittaya PhanuphakRapee TrichavarojWiriya RutvisuttinuntNitiya ChomcheyRobert ParisSheila PeelVictor ValcourFrank MaldarelliNicolas ChomontNelson MichaelPraphan PhanuphakJerome H KimRV254/SEARCH 010 Study Group<h4>Background</h4>Limited knowledge exists on early HIV events that may inform preventive and therapeutic strategies. This study aims to characterize the earliest immunologic and virologic HIV events following infection and investigates the usage of a novel therapeutic strategy.<h4>Methods and findings</h4>We prospectively screened 24,430 subjects in Bangkok and identified 40 AHI individuals. Thirty Thais were enrolled (8 Fiebig I, 5 Fiebig II, 15 Fiebig III, 2 Fiebig IV) of whom 15 completed 24 weeks of megaHAART (tenofovir/emtricitabine/efavirenz/raltegravir/maraviroc). Sigmoid biopsies were completed in 24/30 at baseline and 13/15 at week 24. At baseline, the median age was 29 years and 83% were MSM. Most were symptomatic (87%), and were infected with R5-tropic (77%) CRF01_AE (70%). Median CD4 was 406 cells/mm(3). HIV RNA was 5.5 log(10) copies/ml. Median total blood HIV DNA was higher in Fiebig III (550 copy/10(6) PBMC) vs. Fiebig I (8 copy/10(6) PBMC) (p = 0.01) while the median %CD4+CCR5+ gut T cells was lower in Fiebig III (19%) vs. Fiebig I (59%) (p = 0.0008). After 24 weeks of megaHAART, HIV RNA levels of <50 copies were achieved in 14/15 in blood and 13/13 in gut. Total blood HIV DNA at week 0 predicted reservoir size at week 24 (p<0.001). Total HIV DNA declined significantly and was undetectable in 3 of 15 in blood and 3 of 7 in gut. Frequency of CD4+CCR5+ gut T cells increased from 41% at baseline to 64% at week 24 (p>0.050); subjects with less than 40% at baseline had a significant increase in CD4+CCR5+ T cells from baseline to week 24 (14% vs. 71%, p = 0.02).<h4>Conclusions</h4>Gut T cell depletion and HIV reservoir seeding increases with progression of AHI. MegaHAART was associated with immune restoration and reduced reservoir size. Our findings could inform research on strategies to achieve HIV drug-free remission.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0033948&type=printable
spellingShingle Jintanat Ananworanich
Alexandra Schuetz
Claire Vandergeeten
Irini Sereti
Mark de Souza
Rungsun Rerknimitr
Robin Dewar
Mary Marovich
Frits van Griensven
Rafick Sekaly
Suteeraporn Pinyakorn
Nittaya Phanuphak
Rapee Trichavaroj
Wiriya Rutvisuttinunt
Nitiya Chomchey
Robert Paris
Sheila Peel
Victor Valcour
Frank Maldarelli
Nicolas Chomont
Nelson Michael
Praphan Phanuphak
Jerome H Kim
RV254/SEARCH 010 Study Group
Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.
PLoS ONE
title Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.
title_full Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.
title_fullStr Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.
title_full_unstemmed Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.
title_short Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection.
title_sort impact of multi targeted antiretroviral treatment on gut t cell depletion and hiv reservoir seeding during acute hiv infection
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0033948&type=printable
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