The Control of HIV After Antiretroviral Medication Pause (CHAMP) Study: Posttreatment Controllers Identified From 14 Clinical Studies
Year: 2018
Type: article
Abstract: Background: HIV posttreatment controllers are rare individuals who start antiretroviral therapy (ART), but maintain HIV suppression after treatment interruption. The frequency of posttreatment control and posttreatment interruption viral dynamics have not been well characterized. Methods: Posttreatment controllers were identified from 14 studies and defined as individuals who underwent treatment interruption with viral loads ≤400 copies/mL at two-thirds or more of time points for ≥24 weeks. Viral load and CD4+ cell dynamics were compared between posttreatment controllers and noncontrollers. Results: Of the 67 posttreatment controllers identified, 38 initiated ART during early HIV infection. Posttreatment controllers were more frequently identified in those treated during early versus chronic infection (13% vs 4%, P < .001). In posttreatment controllers with weekly viral load monitoring, 45% had a peak posttreatment interruption viral load of ≥1000 copies/mL and 33% had a peak viral load ≥10000 copies/mL. Of posttreatment controllers, 55% maintained HIV control for 2 years, with approximately 20% maintaining control for ≥5 years. Conclusions: Posttreatment control was more commonly identified amongst early treated individuals, frequently characterized by early transient viral rebound and heterogeneous durability of HIV remission. These results may provide mechanistic insights and have implications for the design of trials aimed at achieving HIV remission.
Authors: Golnaz Namazi, Jesse M Fajnzylber, Evgenia Aga, Ronald J Bosch, Edward P Acosta, Radwa Sharaf, Wendy Hartogensis, Jeffrey M Jacobson, Elizabeth Connick, Paul Volberding, Daniel Skiest, David Margolis, Michael C Sneller, Susan J Little, Sara Gianella, Davey M Smith, Daniel R Kuritzkes, Roy M Gulick, John W Mellors, Vikram Mehraj, Rajesh T Gandhi, Ronald Mitsuyasu, Robert T Schooley, Keith Henry, Pablo Tebas, Steven G Deeks, Tae-Wook Chun, Ann C Collier, Jean-Pierre Routy, Frederick M Hecht, Bruce D Walker, Jonathan Z Li
Institutions: Brigham and Women's Hospital, Harvard University, University of Alabama at Birmingham, University of California, San Francisco, Temple University, University of Arizona, Tufts University, University of North Carolina at Chapel Hill, National Institute of Allergy and Infectious Diseases, University of California San Diego, Weill Cornell Medicine, University of Pittsburgh, McGill University Health Centre, Massachusetts General Hospital, University of California, Los Angeles, University of Minnesota, University of Pennsylvania, University of Washington, Ragon Institute of MGH, MIT and Harvard, Massachusetts Institute of Technology
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: bronze
Funders: amfAR, The Foundation for AIDS Research, AIDS Healthcare Foundation, GlaxoSmithKline, Styrelsen för Internationellt Utvecklingssamarbete, Gilead Sciences, Fred Hutchinson Cancer Research Center, Harvard University, Harvard University Center for AIDS Research, University of Washington, National Institutes of Health, Center for AIDS Research, University of Washington, Canadian Institutes of Health Research, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, National Center for Research Resources, Janssen Pharmaceuticals, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1819583291, G185513119, Mechanisms of Formation and Persistence of Active HIV Reservoirs, G285461174, G3105106561, Cornell Clinical Trials Unit, G3382714297, G342295615, G3810609436, G382034279, Primary Infection Resource Consortium (PIRC), G4161778824, Viral and Immune Determinants of HIV Rebound, Mentoring Translational Research in HIV, G54768859, Role of proviral loci in HIV latency, Statistical and Data Management Center for the AIDS Clinical Trials Group, G6624918829, G6759634997, G6850693600, G7103799864, G7105083719, Effect of Declining Sex Hormones on HIV persistence in HIV Infected Women on ART, Immunologic & Virologic Features of Early HIV Infection, G8633197509, G864826021, Clinical and Translational Science Center (UL1), G9000039438, G9000124410, G9000194059, G9000292181, Weill Cornell Medicine - Rutgers New Jersey Medical School Clinical Trials Unit, Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections, San Diego Center for AIDS Research (SD CFAR), HIV Neurobehavioral Research Center, AIDS Clinical Trial Group Laboratory Center, Statistical and Data Management Center (SDMC), Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections (ACTG), San Francisco Bay Clinical Trials Unit (CTU), UCSF-Bay Area Center for AIDS Research, Harvard University Center for AIDS Research, Boston HIV CTU
OpenAlex ID: W2887935769