HIV-1 RNA and HIV-1 DNA persistence during suppressive ART with PI-based or nevirapine-based regimens

J Antimicrob Chemother. 2015 Dec;70(12):3311-6. doi: 10.1093/jac/dkv250. Epub 2015 Aug 31.

Abstract

Objectives: Whether ART regimens differ in their propensity to allow persistent HIV-1 detection remains unclear. To investigate this, we performed a cross-sectional study to characterize HIV-1 persistence in peripheral blood during suppressive therapy with NRTIs plus a PI or nevirapine.

Methods: Residual plasma HIV-1 RNA was quantified by real-time PCR. Cell-associated proviral total HIV-1 DNA, unspliced and multiply spliced HIV-1 RNA and 2-long terminal repeat (2-LTR) circles were quantified by digital PCR.

Results: Comparing PI with nevirapine recipients, residual plasma HIV-1 RNA detection rates were 47/80 (58.8%) versus 37/81 (45.7%), with median (IQR) levels of 4 (3-8) versus 4 (3-7) copies/mL (P = 0.207); detection was less likely with longer duration of suppressive ART (P = 0.020), independently of treatment. HIV-1 DNA was detected in all patients, with median levels of 2.3 (IQR 2.0-2.7) versus 2.5 (IQR 2.1-2.7) log10 copies/10(6) PBMCs, respectively; HIV-1 DNA levels were associated with pre-ART viral load (P = 0.004) and with residual HIV-1 RNA (P = 0.034), unspliced HIV-1 RNA (P = 0.001) and 2-LTR circles (P = 0.005), independently of treatment.

Conclusions: No significant differences were revealed in levels of residual plasma HIV-1 RNA, total HIV-1 DNA or intracellular markers of ongoing virus replication (unspliced and multiply spliced HIV-1 RNA and 2-LTR circles) between treatment groups.

Publication types

  • Clinical Study
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods*
  • Cross-Sectional Studies
  • DNA, Viral / blood*
  • Female
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / therapeutic use
  • HIV-1 / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Nevirapine / therapeutic use
  • Polymerase Chain Reaction
  • RNA, Viral / blood*
  • Treatment Outcome
  • Viral Load*

Substances

  • Anti-HIV Agents
  • DNA, Viral
  • HIV Protease Inhibitors
  • RNA, Viral
  • Nevirapine