BackgroundThe effect of ART initiation time on HIV-1 DNA reservoir in chronically infected individuals is not well understood. Determining the potential influencing factors associated with a low HIV-1 DNA level in chronic infection is an important step toward drug-free control.MethodsA prospective study included 444 chronically HIV-infected adults was performed. Participants were divided into two groups: early initiation group (EIG) or delayed initiation group (DIG) based on their baseline CD4 count; 350 to 500 and<350 cells/mm(3), respectively. Total HIV-1 DNA was measured by quantitative PCR. Using the Mann-Whitney U test, the HIV-1 DNA level at week 48 was compared between the two groups. The influencing factors of the HIV-1 DNA and factors associated with achieving a low HIV-1 level at week 48 were analyzed.ResultsThe HIV-1 DNA at week 48 in EIG was significantly lower than in DIG [2.12 (1.80-2.51) vs 2.58 (2.21-2.87) log(10) copies/10(6)peripheral blood mononuclear cells (PBMCs); p=0.001]. Early ART initiation was positively associated with lower HIV-1 DNA at week 48 (p=0.025). Similarly, baseline HIV-1DNA (p=0.001) was positively associated with HIV-1DNA at week 48 and baseline CD4/CD8 ratio (p=0.001) was inversely associated with HIV-1DNA at week 48. Early ART initiation (p=0.003) and baseline HIV-1 DNA level (p<0.001) were positively associated with achieving HIV-1 DNA<100 copies/10(6) PBMCs at week 48.ConclusionEarly ART initiation is positively associated with a smaller size of viral reservoir and a higher possibility of achieving a low HIV-1DNA level at week 48 in Chinese chronically HIV-1 infected adult.Trial registrationNCT01844297; Registered 1 May, 2013.
[1]Chinese Acad Med Sci, Dept Infect Dis, Peking Union Med Coll Hosp, 1 Shuaifuyuan,Wangfujing St, Beijing 100730, Peoples R China;
[2]Fudan Univ, Shanghai Publ Hlth Clin Ctr, Shanghai, Peoples R China;
[3]Guangzhou 8 Peoples Hosp, Guangzhou, Guangdong, Peoples R China;
[4]Capital Med Univ, Beijing Youan Hosp, Beijing, Peoples R China;
[5]302 Mil Hosp China, Beijing, Peoples R China;
[6]Infect Dis Hosp Henan Prov, Zhengzhou, Henan, Peoples R China;
[7]Chengdu Infect Dis Hosp, Chengdu, Sichuan, Peoples R China;
[8]First Hosp Changsha, Changsha, Hunan, Peoples R China;
[9]Ctr Dis Prevent & Control Guangxi Prov, Nanning, Peoples R China;
[10]Nanning 4 Peoples Hosp, Nanning 11THE, Peoples R China;
[11]Longtan Hosp, Liuzhou, Peoples R China;
[12]Chinese Med Univ, Hangzhou, Zhejiang, Peoples R China;
[13]Univ Washington, Dept Lab Med, Seattle, WA 98195 USA;
[14]McGill Univ, Hlth Ctr, Res Inst, Chron Viral Illness Serv, Montreal, PQ, Canada;
[15]McGill Univ, Hlth Ctr, Div Hematol, Montreal, PQ, Canada
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