Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy

Initiation of combined antiretroviral therapy within the first 12 weeks of life in vertically human immunodeficiency virus type 1-infected children favors the establishment of low-level proviral reservoirs. Nevertheless, treatment discontinuation in these patients may lead to rapid and irreversible...

Descripción completa

Detalles Bibliográficos
Autores: Martínez-Bonet, Marta, Puertas, Maria C.|||0000-0002-6750-2318, Fortuny Guasch, Claudia, Ouchi, Dan|||0000-0002-8630-152X, Mellado, Maria José, Rojo, Pablo, Noguera-Julian, Antoni|||0000-0001-7485-0583, Muñoz Fernández, María Ángeles, Martínez Picado, Francisco Javier|||0000-0002-4916-2129
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:185350
Acceso en línea:https://ddd.uab.cat/record/185350
https://dx.doi.org/urn:doi:10.1093/cid/civ456
Access Level:acceso abierto
Palabra clave:HIV-1
Vertical infection
Early antiretroviral therapy
Viral reservoir
id ES_5e9b8d12d936ee069fe8a2d28694a2d9
oai_identifier_str oai:ddd.uab.cat:185350
network_acronym_str ES
network_name_str España
repository_id_str
spelling Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral TherapyMartínez-Bonet, MartaPuertas, Maria C.|||0000-0002-6750-2318Fortuny Guasch, ClaudiaOuchi, Dan|||0000-0002-8630-152XMellado, Maria JoséRojo, PabloNoguera-Julian, Antoni|||0000-0001-7485-0583Muñoz Fernández, María ÁngelesMartínez Picado, Francisco Javier|||0000-0002-4916-2129HIV-1Vertical infectionEarly antiretroviral therapyViral reservoirInitiation of combined antiretroviral therapy within the first 12 weeks of life in vertically human immunodeficiency virus type 1-infected children favors the establishment of low-level proviral reservoirs. Nevertheless, treatment discontinuation in these patients may lead to rapid and irreversible expansion of reservoir size. Background. Combination antiretroviral therapy (cART) generally suppresses the replication of the human immunodeficiency virus type 1 (HIV-1) but does not cure the infection, because proviruses persist in stable latent reservoirs. It has been proposed that low-level proviral reservoirs might predict longer virologic control after discontinuation of treatment. Our objective was to evaluate the impact of very early initiation of cART and temporary treatment interruption on the size of the latent HIV-1 reservoir in vertically infected children. Methods. This retrospective study included 23 perinatally HIV-1-infected children who initiated very early treatment within 12 weeks after birth (n = 14), or early treatment between week 12 and 1 year (n = 9). We measured the proviral reservoir (CD4 + T-cell-associated HIV-1 DNA) in blood samples collected beyond the first year of sustained virologic suppression. Results. There is a strong positive correlation between the time to initiation of cART and the size of the proviral reservoir. Children who initiated cART within the first 12 weeks of life showed a proviral reservoir 6-fold smaller than children initiating cART beyond this time (P <.01). Rapid virologic control after initiation of cART also limits the size of the viral reservoir. However, patients who underwent transient treatment interruptions showed a dramatic increase in the size of the viral reservoir after discontinuation. Conclusions. Initiation of cART during the first 12 weeks of life in perinatally HIV-1-infected children limits the size of the viral reservoir. Treatment interruptions should be undertaken with caution, as they might lead to fast and irreversible replenishment of the viral reservoir.Universitat Autònoma de Barcelona 22015-01-0120152015-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/185350https://dx.doi.org/urn:doi:10.1093/cid/civ456reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:1853502026-06-06T12:50:31Z
dc.title.none.fl_str_mv Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
title Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
spellingShingle Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
Martínez-Bonet, Marta
HIV-1
Vertical infection
Early antiretroviral therapy
Viral reservoir
title_short Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
title_full Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
title_fullStr Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
title_full_unstemmed Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
title_sort Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy
dc.creator.none.fl_str_mv Martínez-Bonet, Marta
Puertas, Maria C.|||0000-0002-6750-2318
Fortuny Guasch, Claudia
Ouchi, Dan|||0000-0002-8630-152X
Mellado, Maria José
Rojo, Pablo
Noguera-Julian, Antoni|||0000-0001-7485-0583
Muñoz Fernández, María Ángeles
Martínez Picado, Francisco Javier|||0000-0002-4916-2129
author Martínez-Bonet, Marta
author_facet Martínez-Bonet, Marta
Puertas, Maria C.|||0000-0002-6750-2318
Fortuny Guasch, Claudia
Ouchi, Dan|||0000-0002-8630-152X
Mellado, Maria José
Rojo, Pablo
Noguera-Julian, Antoni|||0000-0001-7485-0583
Muñoz Fernández, María Ángeles
Martínez Picado, Francisco Javier|||0000-0002-4916-2129
author_role author
author2 Puertas, Maria C.|||0000-0002-6750-2318
Fortuny Guasch, Claudia
Ouchi, Dan|||0000-0002-8630-152X
Mellado, Maria José
Rojo, Pablo
Noguera-Julian, Antoni|||0000-0001-7485-0583
Muñoz Fernández, María Ángeles
Martínez Picado, Francisco Javier|||0000-0002-4916-2129
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv HIV-1
Vertical infection
Early antiretroviral therapy
Viral reservoir
topic HIV-1
Vertical infection
Early antiretroviral therapy
Viral reservoir
description Initiation of combined antiretroviral therapy within the first 12 weeks of life in vertically human immunodeficiency virus type 1-infected children favors the establishment of low-level proviral reservoirs. Nevertheless, treatment discontinuation in these patients may lead to rapid and irreversible expansion of reservoir size. Background. Combination antiretroviral therapy (cART) generally suppresses the replication of the human immunodeficiency virus type 1 (HIV-1) but does not cure the infection, because proviruses persist in stable latent reservoirs. It has been proposed that low-level proviral reservoirs might predict longer virologic control after discontinuation of treatment. Our objective was to evaluate the impact of very early initiation of cART and temporary treatment interruption on the size of the latent HIV-1 reservoir in vertically infected children. Methods. This retrospective study included 23 perinatally HIV-1-infected children who initiated very early treatment within 12 weeks after birth (n = 14), or early treatment between week 12 and 1 year (n = 9). We measured the proviral reservoir (CD4 + T-cell-associated HIV-1 DNA) in blood samples collected beyond the first year of sustained virologic suppression. Results. There is a strong positive correlation between the time to initiation of cART and the size of the proviral reservoir. Children who initiated cART within the first 12 weeks of life showed a proviral reservoir 6-fold smaller than children initiating cART beyond this time (P <.01). Rapid virologic control after initiation of cART also limits the size of the viral reservoir. However, patients who underwent transient treatment interruptions showed a dramatic increase in the size of the viral reservoir after discontinuation. Conclusions. Initiation of cART during the first 12 weeks of life in perinatally HIV-1-infected children limits the size of the viral reservoir. Treatment interruptions should be undertaken with caution, as they might lead to fast and irreversible replenishment of the viral reservoir.
publishDate 2015
dc.date.none.fl_str_mv 2
2015-01-01
2015
2015-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/185350
https://dx.doi.org/urn:doi:10.1093/cid/civ456
url https://ddd.uab.cat/record/185350
https://dx.doi.org/urn:doi:10.1093/cid/civ456
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869409140352221185
score 15,301629

Similares en LA Referencia