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  1. Clin Infect Dis. (2015) doi: 10.1093/cid/civ171First published online: March 3, 2015
Impact of the Earliness of Antiretroviral Therapy Initiation During Primary HIV-1 Infection on the Decay of Cell-Associated HIV-DNA
Moussa Laanani1,2,
1Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Paris-Sud University, Le Kremlin-Bicêtre, France
2APHP, Department of Epidemiology and Public Health, Bicêtre Hospital, Le Kremlin-Bicêtre, France
Background. Combined antiretroviral therapy (cART) initiation during primary HIV infection (PHI) yields larger decrease in cell-associated HIV-DNA (CA-HIV-DNA) than initiation during the chronic phase. Our objective was to model the short and long-term decay of CA-HIV-DNA blood reservoir in patients initiating cART during PHI and to assess the impact of the earliness of cART initiation on CA-HIV-DNA decay.
Methods. We included patients enrolled during PHI in the ANRS PRIMO cohort, treated within the month following enrollment and achieving sustained virological response. The decay of CA-HIV-DNA over time while on successful cART was modeled with a 3-slope linear mixed-effects model according to the delay between estimated date of infection and cART initiation.
Results. 327 patients were included, accounting for 1,305 CA-HIV-DNA quantifications. Median time between infection and cART initiation was 41 days (IQR: 33-54). Median follow-up under cART was 2.3 years (range: 0.4-16.6). The earliness of cART initiation had significant impact on the first slope of decrease: the earlier cART was initiated after HIV infection, the faster CA-HIV-DNA level decreased during the first 8 months of cART: -0.171, -0.131, and -0.068 log10 copies/106 PBMC/month when cART was initiated 15 days, 1 month and 3 months after infection, respectively.
Conclusions. This study provides strong arguments in favor of cART initiation at the earliest possible time point after HIV infection.
Nelson Vergel
Nelson Vergel
Chemical engineer, 34+ year HIV and cancer survivor, health author and educator . Founder of , , and

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