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CROI 2013: Viral “Reservoir” Study Supports Early Treatment

, by San Francisco AIDS Foundation

A study presented at last week’s 20th Conference on Retroviruses and Opportunistic Infections adds to a growing body of evidence suggesting that treating HIV in the very earliest days following infection can prevent the virus from establishing “reservoirs”—places where the virus hides, undetected by immune system cells and untouchable by antiretroviral treatment.

Individuals whose HIV infection was confirmed very early in the “acute” infection stage (using tests that look for HIV’s genetic material, not the body’s own antibodies against the virus) and who who started antiretroviral therapy (ART) within just days after diagnosis exhibited extremely low reservoir size compared with individuals diagnosed and treated later, explained presenter Jintanat Ananworanich, MD.

See “Early Treatment Cuts Infection of Resting CD4 Cells” for more about viral reservoirs and to learn why most people in acute infection don’t yet know they have HIV.

Although the study is small, with only 68 individuals included in this analysis, the finding has implications for the search for a functional cure, in which HIV is not eradicated from the body but is kept in check without lifelong antiretroviral therapy. “Acute HIV infection,” the research team noted in the conference abstract, “represents a window of opportunity to intervene to limit reservoir seeding.”

The study abstract is available here, and you can also watch a webcast of Dr. Ananworanich’s presentation. A summary of the findings, by Warren Tong, is excerpted below and available in full at TheBodyPRO.com.

Very Early HIV Treatment May Limit “Seeding” of Latent HIV Reservoirs, Study Finds

By Warren Tong

March 5, 2013

Early HIV treatment, specifically during acute HIV infection, can limit the virus from forming HIV reservoirs in central memory CD4+ cells, according to study results presented at CROI 2013 in Atlanta, Ga.

Researchers in Thailand screened 52,767 patients for HIV using both nucleic acid tests (NAT) and enzyme-linked immunosorbent assay (ELISA) tests. Only 89 were identified as having acute HIV infection. Of these, 75 were enrolled in the study within three days and then started on antiretroviral therapy within an additional two days.

Lead author Jintanat Ananworanich, M.D., presented findings on the first 68 participants. The median age was 29 and 91% were men who have sex with men. The median duration of infection at baseline was only 15 days….

Read the full summary at TheBodyPRO.com.


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