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Integrated HIV DNA accumulates prior to treatment while episomal HIV DNA records ongoing transmission afterwards.
MedLine Citation:
PMID:  22410637     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: We investigated the dynamics of HIV RNA and HIV DNA levels after the commencement of raltegravir-based antiretroviral therapy (ART) in primary (PHI) and chronically HIV-infected (CHI) individuals (the PINT study). DESIGN:: We recruited 8 PHI and 8 CHI ART-naive individuals who commenced a 1-year combination regimen of Truvada and the integrase inhibitor raltegravir. METHODS:: Nonlinear mixed effects modelling was used to determine multiphasic decay of plasma HIV RNA levels (pVL), as well as dynamics of total, episomal [2-long terminal repeats (LTR)] and integrated HIV DNA in CD4 T cells from peripheral blood. RESULTS:: Although pVL decreased faster through first and second phase for PHI individuals there was no difference in the final level reaching a mean of 9 copies/ml by week 16 that was maintained thereafter. Total HIV DNA and integrated HIV DNA levels from CHI patients were significantly higher than from PHI patients. However, at no time did 2-LTR levels differ between groups. Of note, 2-LTR circles exhibited an initial increase peaking at week 3 followed by biphasic decay with a half-life of 29 days. Second phase integrated HIV DNA levels were significantly correlated with duration of infection and consistent with this form of infection occurring at approximately 100 000 integration events per day in the absence of ART, achieving its 50% level 2 years after infection. CONCLUSIONS:: Integrated HIV DNA levels accumulate with duration of untreated HIV infection. The relatively short half-life and high levels of 2-LTR circles after 1 year support continued HIV transmission during ART.
Authors:
John M Murray; Kristin McBride; Christoph Boesecke; Michelle Bailey; Janaki Amin; Kazuo Suzuki; David Baker; John J Zaunders; Sean Emery; David A Cooper; Kersten K Koelsch; Anthony D Kelleher;
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  AIDS (London, England)     Volume:  26     ISSN:  1473-5571     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  -    
Other Details:
Languages:  ENG     Pagination:  543-550     Citation Subset:  -    
Affiliation:
aSchool of Mathematics and Statistics, University of New South Wales bThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia cDepartment of Internal Medicine I, University of Bonn, Bonn, Germany dSt Vincent's Hospital, Sydney, Centre for Applied Medical Research eEast Sydney Doctors, Darlinghurst, New South Wales, Australia. *These authors contributed equally to this study.
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