6533b7d9fe1ef96bd126c2b5
RESEARCH PRODUCT
Pre-ART HIV-1 DNA in CD4+ T cells correlates with baseline viro-immunological status and outcome in patients under first-line ART
F Ceccherini-silbersteinA Cozzi LepriC AlteriE MerliniM SurdoG MarchettiMr CapobianchiA De LucaN GianottiP VialeM AndreoniA AntinoriCf PernoA D'arminio MonforteA D'arminio MonforteA AntinoriA CastagnaF CastelliR CaudaG Di PerriM GalliR IardinoG IppolitoA LazzarinGc MarchettiCf PernoG RezzaF Von SchloesserP VialeA D'arminio MonforteA AntinoriA CastagnaF Ceccherini-silbersteinA Cozzi-lepriE GirardiS Lo CaputoC MussiniM PuotiCf PernoM AndreoniA AmmassariA AntinoriC BalottaA BanderaP BonfantiS BonoraM BorderiA CalcagnoL CalzaMr CapobianchiA CastagnaF Ceccherini-silbersteinA CingolaniP CinqueA Cozzi-lepriA D'arminio MonforteA De LucaA Di BiagioE GirardiN GianottiA GoriG GuaraldiG LapadulaM LichtnerS Lo CaputoG MadedduF MaggioloG MarchettiS MarcotullioL MonnoC MussiniS NozzaM PuotiE Quiros RoldanR RossottiS RusconiMm SantoroA SaracinoM ZaccarelliA Cozzi-lepriI FantiL GalliP LorenziniA RodanoM ShanyindeA TavelliF CarlettiS CarraraA Di CaroS GrazianoF PetroneG ProtaS QuartuS TruffaA GiacomettiA CostantiniV BarocciG AngaranoL MonnoC SantoroF MaggioloC SuardiP VialeV DonatiG VerucchiF CastelliC MinardiE Quiros RoldanT QuirinoC AbeliPe ManconiP PianoB CacopardoB CelesiaJ VecchietK FalascaL SighinolfiD SegalaP BlancF VichiG CassolaC ViscoliA AlessandriniN BobbioG MazzarelloC MastroianniI PozzettoP BonfantiC MolteniA ChioderaP MiliniG NunnariG PellicanòA D'arminio MonforteM GalliA LazzarinG RizzardiniM PuotiA CastagnaG MarchettiMc MoioliR PioliniAl RidolfoS SalpietroC TincatiC MussiniC PuzzolanteA GoriG LapadulaA ChirianniG BorgiaV EspositoR OrlandoG BonadiesF Di MartinoI GentileL MaddaloniAm CattelanS MarinelloA CascioC ColombaF BaldelliE SchiaroliG ParrutiF SozioG MagnaniMa UrsittiM AndreoniA AntinoriR AcinapuraG BaldinM CapozziR CaudaS CicaliniA CingolaniA CristaudoL Fontanelli SulekovaG IaianiA LatiniI MastrorosaMm PlazziS SavinelliA VergoriV VulloM CecchettoF VivianiG MadedduP BagellaA De LucaB RossettiA FrancoR Fontana Del VecchioD FrancisciC Di GiuliP CaramelloG Di PerriS BonoraGc OrofinoM SciandraM BassettiA LonderoG PellizzerV ManfrinG StarniniA. Ialungosubject
0301 basic medicineOncologyCD4-Positive T-LymphocytesMaleHIV InfectionsSettore MED/07chemistry.chemical_compoundHIV InfectionPharmacology (medical)ViralProspective StudiesProspective cohort studyAntiinfective agentAdult; Anti-Retroviral Agents; CD4-Positive T-Lymphocytes; DNA Viral; Female; HIV Infections; HIV-1; Humans; Male; Middle Aged; Prospective Studies; Survival Analysis; Treatment Outcome; Viral LoadMiddle AgedViral LoadvirologyHIV CD4Stavudinemedicine.anatomical_structureInfectious DiseasesTreatment Outcomehiv-1 t-lymphocytes virology blood hiv rna hiv dnaAnti-Retroviral AgentsCD4-Positive T-Lymphocyteblood hiv rnaCohorthiv dnaFemaleSurvival AnalysiViral loadARTHumanMicrobiology (medical)Adultmedicine.medical_specialtyAntiretroviral Therapy CD4 Lymphocyte Count StavudineT cellAntiretroviral TherapySettore MED/17 - MALATTIE INFETTIVENO03 medical and health sciencesInternal medicinemedicineHumanst-lymphocytesSurvival analysisPharmacologybusiness.industryProportional hazards modelHIVDNASurvival AnalysisCD4 Lymphocyte CountProspective Studie030104 developmental biologychemistryDNA ViralHIV-1Anti-Retroviral AgentbusinessDNAdescription
Objectives We evaluated the association between pre-ART HIV DNA and HIV-infected participant characteristics at baseline as well as with their response to first-line ART. Methods Four hundred and thirty-three patients from the ICONA cohort, starting first-line ART after the year 2000, were analysed. Pre-ART HIV DNA was quantified with the modified COBAS TaqMan HIV-1 Test and normalized by CD4+ T cells. Linear correlation between pre-ART HIV DNA and other continuous markers (HIV RNA, CD4 count, markers of inflammation and coagulation) at baseline was evaluated by means of Pearson correlation coefficient and a linear regression model. Survival analyses and Cox regression models were used to study the association between pre-ART HIV DNA and time to VIRO-immunoclinical events. Results Pre-ART HIV DNA [median (IQR): 10 € 702 (3397-36 € 632) copies/10 6 CD4+ T cells] was correlated with pre-ART HIV RNA [R 2 = +0.44, (P < 0.0001)], CD4+ T cells [R 2 = '0.58, (P < 0.0001)] and CD4/CD8 ratio [R 2 = '0.48, (P < 0.0001)], while weaker correlations were observed with CD8+ T cells (R 2 = '0.20, P = 0.01), IL-6 (R 2 = +0.16, P = 0.002) and soluble CD14 (R 2 = +0.09, P = 0.05). Patients with higher pre-ART HIV DNA showed lower rate and delayed VIROlogical response (defined as HIV RNA ≤50 copies/mL), compared with those having lower HIV DNA (67.2% for >10 € 000, 81.1% for 1000-10 € 000 and 86.4% for 10-1000 copies/10 6 CD4+ T cells; P = 0.0004). Higher pre-ART HIV DNA was also correlated with increased risk of VIROlogical rebound (defined as HIV RNA >50 copies/mL) by 24 months (17.2% for >10 € 000, 7.4% for 1000-10 € 000 and 4.3% for 10-1000 copies/10 6 CD4+ T cells; P = 0.0048). Adjusted HRs of all VIROlogical rebound definitions confirmed these findings (P ≤ 0.02). Conclusions Pre-ART HIV DNA, along with HIV RNA and CD4+ T cell count, should be considered as a new staging marker to better identify people at lower (or higher) risk of viral rebound following achievement of VIROlogical suppression (≤50 copies/mL).
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-09-20 |