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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
Published on: September 26, 2011
Sustained Virologic Suppression Reduces HIV-1 DNA Proviral Levels and HIV Antibodies in Perinatally HIV-Infected
Trevon Fuller1,2, Tara Kerin3, Ruth Cortado3
1Institute of the Environment & Sustainability, University of California Los Angeles, Los Angeles, CA 90095, USA.
Insights
Long-term viral suppression in children with perinatal HIV infection is linked to reduced HIV reservoirs and lower HIV antibody levels. Early combination antiretroviral therapy (cART) helps achieve this, impacting HIV DNA and RNA viral loads.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Immunology
Background:
- Perinatally HIV-infected children on combination antiretroviral therapy (cART) may develop low proviral reservoirs.
- The impact of cART timing and duration on HIV DNA levels and antibody responses in these children is not fully understood.
Purpose of the Study:
- To investigate the long-term proviral HIV DNA reservoir size and HIV antibody levels in perinatally HIV-infected children after initiating cART.
- To assess the correlation between the timing of cART initiation, viral load suppression, and reservoir size.
Main Methods:
- Prospective study of 37 perinatally HIV-infected children initiating stable cART before 6 months or after 6 months of age.
- Measurement of plasma HIV RNA viral load (VL), proviral HIV DNA using droplet-digital PCR (ddPCR), and HIV antibody by Western Blot (WB) at school age (6-11 years).
Main Results:
- HIV DNA levels at school age did not significantly differ based on cART initiation timing.
- Children with negative/indeterminate Western Blot (WB) results had significantly lower HIV DNA levels (p=0.0256).
- Children with >50% undetectable HIV RNA VL since cART initiation showed a trend towards lower median HIV DNA VL (p=0.07).
Conclusions:
- Long-term viral suppression in perinatally HIV-infected children is associated with decreased HIV antibody levels.
- Reduced HIV proviral DNA reservoirs are linked to sustained viral suppression and potentially negative/indeterminate HIV antibody status.
Abstract:
The extent to which perinatally HIV-infected children, following cART initiation, develop a low proviral reservoir burden over time, as measured by HIV DNA droplet-digital polymerase chain reaction (ddPCR) and the effect on HIV antibody is not well characterized. We measured proviral HIV DNA and plasma RNA virus load (VL) in 37 perinatally HIV-infected children at 6 months of age who initiated stable cART. At 6-11 years of age, HIV proviral DNA, HIV VL (RNA), and HIV antibody by Western Blot (WB) were assessed. CART was initiated before 6 months of age in 13 children and after 6 months in 24. At school age, the HIV DNA levels did not differ by the timing of cART, and the HIV DNA levels were lower in children with negative/indeterminate WB (p = 0.0256). Children with undetectable HIV RNA VL > 50% of the time since cART initiation had lower median DNA VL than children with undetectable VL < 50% of the time (p = 0.07). Long-term viral suppression in perinatally HIV-infected children is associated with a decrease in HIV antibodies and reduced HIV reservoirs.
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