Duration of HIV-1 Viral Suppression on Cessation of Antiretroviral Therapy in Primary Infection Correlates with Time on Therapy

作者：Stoehr Wolfgang; Fidler Sarah; McClure Myra; Weber Jonathan; Cooper David; Ramjee Gita; Kaleebu Pontiano; Tambussi Giuseppe; Schechter Mauro; Babiker Abdel; Phillips Rodney E; Porter Kholoud; Frater John^*

来源：PLos One, 2013, 8(10): e78287.

DOI：10.1371/journal.pone.0078287

Objective: A minority of HIV-1 positive individuals treated with antiretroviral therapy (ART) in primary HIV-1 infection (PHI) maintain viral suppression on stopping. Whether this is related to ART duration has not been explored. %26lt;br%26gt;Design: And Methods: Using SPARTAC trial data from individuals recruited within 6 months of seroconversion, we present an observational analysis investigating whether duration of ART was associated with post-treatment viraemic control. Kaplan-Meier estimates, logistic regression and Cox models were used. %26lt;br%26gt;Results: 165 participants reached plasma viral loads (VL) %26lt;400 copies/ml at the time of stopping therapy (ART stop). After ART stop, 159 experienced confirmed VL %26gt;= 400 copies/ml during median (IQR) follow-up of 167 (108,199) weeks. %26lt;br%26gt;Most participants experienced VL rebound within 12 weeks from ART stop, however, there was a suggestion of a higher probability of remaining %26lt;400 copies/ml for those on ART %26gt;12 weeks compared to %26lt;= 12 weeks (p=0.061). Cumulative probabilities of remaining %26lt;400 copies/ml at 12, 52 and 104 weeks after ART stop were 21% (95% CI= 13,30), 4% (1,9), and 4% (1,9) for %26lt;= 12 weeks ART, and 32% (22,42), 14% (7,22), and 5% (2,11) for %26gt;12 weeks. %26lt;br%26gt;In multivariable regression, ART for %26gt;12 weeks was independently associated with a lower probability of being %26gt;= 400 copies/ml within 12 weeks of ART stop (OR=0.11 (95% CI=0.03,0.34), p%26lt;0.001)). In Cox models of time to VL %26gt;= 400 after 12 weeks, we only found an association with female sex (OR=0.2, p=0.001). %26lt;br%26gt;Conclusion: Longer ART duration in PHI was associated with a higher probability of viral control after ART stop.

• 出版日期2013-10-25