@article{36abbe97fdd74297bfd0f018e123dceb,
title = "Human immunodeficiency virus type 1 DNA decay dynamics with early, long-term virologic control of perinatal infection",
abstract = "Background. Early antiretroviral therapy (ART) limits proviral reservoirs, a goal for human immunodeficiency virus type 1 (HIV-1) remission strategies. Whether this is an immediate or long-term effect of virologic suppression (VS) in perinatal infection is unknown. Methods. We quantified HIV-1 DNA longitudinally for up to 14 years in peripheral blood mononuclear cells (PBMCs) among 61 perinatally HIV-1–infected youths in the Pediatric HIV/AIDS Cohort Study who achieved VS at different ages. Participants in group 1 (n = 13) were <1 year of age and in group 2 (n = 48) from 1 through 5 years of age at VS. Piecewise linear mixed-effects regression models assessed the effect of age at VS on HIV-1 DNA trajectories during VS. Results. In the first 2 years following VS, HIV-1 DNA levels decreased by –0.25 (95% confidence interval [CI], –.36 to –.13) log10 copies/million PBMCs per year and was faster with early VS by age 1 year compared with after age 1 (–0.50 and –0.15 log10 copies/ million PBMCs per year, respectively). Between years 2 and 14 from VS, HIV-1 DNA decayed by –0.05 (95% CI, –.06 to –.03) log10 copies/million PBMCs per year and was no longer significantly different between groups. The estimated mean half-life of HIV-1 DNA from VS was 15.9 years and was shorter for group 1 compared to group 2 at 5.9 years and 18.8 years, respectively (P = .09). Adjusting for CD4 cell counts had no effect on decay estimates. Conclusions. Early effective, long-term ART initiated from infancy leads to decay of HIV-1–infected cells to exceedingly low concentrations desired for HIV-1 remission strategies.",
keywords = "Early ART, HIV-1 DNA decay, Perinatal HIV-1 infection",
author = "{Pediatric HIV/AIDS Cohort Study (PHACS)} and Priyanka Uprety and Kunjal Patel and Brad Karalius and Carrie Ziemniak and Chen, {Ya Hui} and Brummel, {Sean S.} and Suzanne Siminski and {Van Dyke}, {Russell B.} and Seage, {George R.} and Deborah Persaud",
note = "Funding Information: We thank the children and families for their participation in Pediatric HIV/AIDS Cohort Study (PHACS), and the individuals and institutions involved in the conduct of PHACS. The study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) with co-funding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases (NIAID), the Office of AIDS Research, the National Institute of Mental Health (NIMH), the National Institute of Neurological Disorders and Stroke, the National Institute on Deafness and Other Communication Disorders, the National Heart, Lung and Blood Institute, the National Institute of Dental and Craniofacial Research, and the National Institute on Alcohol Abuse and Alcoholism, through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102) (Principal Investigator [PI]: George Seage; Project Director: Julie Alperen) and the Tulane University School of Medicine (HD052104) (PI: Russell Van Dyke; Co-PIs: Kenneth Rich, Ellen Chadwick; Project Director: Patrick Davis). Data management services were provided by Frontier Science and Technology Research Foundation (PI: Suzanne Siminski), and regulatory services and logistical support were provided by Westat, Inc (PI: Julie Davidson). This study was also supported by grants to D. P. from the NIH (RO1 HD080474) and from the Johns Hopkins University Center for AIDS Research (P30AI094189). Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) was provided by the NIH/NIAID under award numbers UM1AI068632 (IMPAACT LOC), UM1AI068616 (IMPAACT SDMC), and UM1AI106716 (IMPAACT LC), with co-funding from the NICHD and NIMH. Publisher Copyright: {\textcopyright} The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.",
year = "2017",
month = jun,
day = "1",
doi = "10.1093/cid/cix192",
language = "English (US)",
volume = "64",
pages = "1471--1478",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "11",
}