Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/103067
Title: Structured Treatment Interruptions and Low Doses of IL-2 in Patients with Primary HIV Infection. Inflammatory, Virological and Immunological Outcomes
Author: Sued, Omar
Ambrosioni, Juan
Nicolás, David
Manzardo, Christian
Agüero, Fernando
Claramonte, Xavier
Plana Prades, Montserrat
Tuset Creus, Montserrat
Pumarola Suñé, Tomás
Gallart, Teresa
Gatell, José M.
Miró Meda, José M.
Keywords: Antiretrovirals
Infeccions per VIH
VIH (Virus)
Resposta immunitària
Inflamació
Antiretroviral agents
HIV infections
HIV (Viruses)
Immune response
Inflammation
Issue Date: 17-Jul-2015
Publisher: Public Library of Science (PLoS)
Abstract: BACKGROUND: Interventions during primary HIV infection (PHI) can modify the clinical course during the chronic phase. The long-term effect of structured treatment interruptions (STI) followed by low doses of interleukin-2 (IL-2) in treated PHI patients is unknown. METHODS: Twelve PHI patients with viral load (VL) <20 copies/mL, CD4 cells >500 cells/mm3, and CD4/CD8 ratio >1, on antiretroviral therapy (ART) initiated within the first 90 days of infection and continued for at least 12 months were included. They underwent four STI and were then allocated (week 0 of the study) to ART alone or ART plus low doses of IL-2. ART was stopped once VL <20 copies/mL ('final stop'). Primary endpoints were VL<3000 copies/mL and CD4 cells >500 cells/mm3 at 48 weeks; secondary endpoints were immune activation, inflammatory markers until 48 weeks and the time before resuming ART (CD4 <350 cells/mm3 or AIDS) after 'final stop', compared between groups. RESULTS: Ten out of 12 patients were males, median age was 35 years and the main risk was men-who-have-sex-with-men. Only one out of 12 patients (in the STI group) maintained VL<3000 copies/mL and CD4 cells >500 cells/mm3 without ART at 48 weeks. All other virological and immunological parameters were comparable between groups at week 0, 'final stop' and week 48. However, the proportion of CD8-CD38+ cells, tumor necrosis factor and srIL-2 were higher in the IL-2 group at 'final stop' and week 24. All these differences vanished during follow-up. At 5 years after the final stop 3 out of 6 patients in the IL-2 group and 6 out of 6 patients in the STI group have resumed ART (P = 0.19). CONCLUSIONS: STI and IL-2 failed to achieve virological control after ART interruption. STI were not deleterious in long-term follow-up, an important issue for eradication and functional cure trials.
Note: Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0131651
It is part of: PLoS One, 2015, vol. 10, num. 7, p. e0131651
Related resource: http://dx.doi.org/10.1371/journal.pone.0131651
URI: http://hdl.handle.net/2445/103067
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)

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