Structured treatment interruptions (STIs) in HIV-1 infected pediatric populations increases interferon gamma production and reduces viremia

Vaccine. 2008 Jun 6;26(24):3086-9. doi: 10.1016/j.vaccine.2007.12.017. Epub 2008 Jan 4.

Abstract

We assessed the effect of progressively longer antiretroviral structured treatment interruptions (STIs) starting with 3 days, increasing by 2 days in length each cycle on HIV-specific immune responses. As well, we correlated these responses with control of HIV viremia. Eight individuals became viremic and reached cycle 13 with an STI of > or =27 days. HIV-specific gamma-interferon production to inactivated HIV and vaccinia vectors expressing gag, env, nef, and pol increased (>10-fold) in six of eight subjects. Median plasma RNA levels peaked @ cycle 7 and declined to levels <10(4)cp/ml after cycle 10. In a subset of five who reached cycle 17, HIV-specific IFN-gamma frequencies increased from cycle 8 to cycle 17 with evidence of improved virologic control over comparable periods off antiretroviral therapy. This allowed us to conclude that exposure to autologous virus increased HIV-specific immune responses and decreased HIV RNA were seen in those who have had >13 interruptions, with STI intervals that exceeded 27 days.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / methods*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Drug Administration Schedule
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV-1 / drug effects*
  • HIV-1 / immunology
  • Humans
  • Interferon-gamma / immunology*
  • RNA, Viral / blood
  • Time Factors
  • Viral Load
  • Viremia / drug therapy*
  • Viremia / immunology

Substances

  • Anti-HIV Agents
  • RNA, Viral
  • Interferon-gamma