Work

29 Impact of adjunctive metformin therapy on T cell exhaustion and viral persistence in a clinical trial of HIV-infected adults on suppressive ART

Year: 2017

Type: article

Abstract: cyclophosphamide for graft-versus-host-disease (GvHD) prophylaxis.The primary outcome was ART continuation through day 60.We measured the LR using a quantitative virus outgrowth assay (qVOA) to determine infected CD4+ T-cells per million (IUPM) and digital droplet PCR to measure proviral DNA in peripheral blood mononuclear cells.Results: All participants (n=7) continued ART through day 60.No adverse events related to ENF occurred.A median of 2 (range 1-3) ART changes was required.One patient developed grade-4 meningoencephalitis with HIV rebound at 4 months due to selfinterruption of ART.All other participants maintained undetectable plasma HIV-RNA.There were no cases of graft failure, grade-3/4 GvHD, or relapsed malignancy.Four patients achieved complete donor chimerism.Of these, 1-2 log increases in proviral DNA were observed in 2 patients, but all had undetectable proviral DNA by week 24, and 2-3 log decreases in the LR by qVOA to undetectable levels.Two patients with incomplete chimerism (persistent host cells) had increases in the LR by qVOA and minimal changes in proviral DNA.Conclusions: We found that continuing ART with optimized regimens that included ENF during alloBMT was feasible and safe in HIV+ alloBMT recipients.In contrast, ART interruption can cause lifethreatening HIV rebound.Significant reductions in the LR are seen in individuals who achieve full donor chimerism but complete viral eradication cannot be proved.29

Source: Journal of Virus Eradication

DOI: 10.1016/s2055-6640(20)30734-2