Article thumbnail

Pre-ART HIV-1 DNA in CD4+ T cells correlates with baseline VIRO-immunological status and outcome in patients under first-line ART

By F. Ceccherini-Silberstein, A. Cozzi Lepri, C. Alteri, E. Merlini, M. Surdo, G. Marchetti, M. R. Capobianchi, A. De Luca, N. Gianotti, P. Viale, M. Andreoni, A. Antinori, C. F. Perno, D&apos, A. Castagna, F. Castelli, R. Cauda, G. Di Perri, M. Galli, R. Iardino, G. Ippolito, A. Lazzarin, G. C. Marchetti, G. Rezza, F. Von Schloesser, A. Cozzi-Lepri, E. Girardi, S. Lo Caputo, C. Mussini, M. Puoti, A. Ammassari, C. Balotta, A. Bandera, P. Bonfanti, S. Bonora, M. Borderi, A. Calcagno, L. Calza, A. Cingolani, P. Cinque, A. Di Biagio, A. Gori, G. Guaraldi, G. Lapadula, M. Lichtner, G. Madeddu, F. Maggiolo, S. Marcotullio, L. Monno, S. Nozza, E. Quiros Roldan, R. Rossotti, S. Rusconi, M. M. Santoro, A. Saracino, M. Zaccarelli, I. Fanti, L. Galli, P. Lorenzini, A. Rodano, M. Shanyinde, A. Tavelli, F. Carletti, S. Carrara, A. Di Caro, S. Graziano, F. Petrone, G. Prota, S. Quartu, S. Truffa, A. Giacometti, A. Costantini, V. Barocci, G. Angarano, C. Santoro, C. Suardi, V. Donati, G. Verucchi, C. Minardi, T. Quirino, C. Abeli, P. E. Manconi, P. Piano, B. Cacopardo, B. Celesia, J. Vecchiet, K. Falasca, L. Sighinolfi, D. Segala, P. Blanc, F. Vichi, G. Cassola, C. Viscoli, A. Alessandrini, N. Bobbio, G. Mazzarello, C. Mastroianni, I. Pozzetto, C. Molteni, A. Chiodera, P. Milini, G. Nunnari, G. Pellicano, G. Rizzardini, M. C. Moioli, R. Piolini, A. L. Ridolfo, S. Salpietro, C. Tincati, C. Puzzolante, A. Chirianni, G. Borgia, V. Esposito, R. Orlando, G. Bonadies, F. Di Martino, I. Gentile, L. Maddaloni, A. M. Cattelan, S. Marinello, A. Cascio, C. Colomba, F. Baldelli, E. Schiaroli, G. Parruti, F. Sozio, G. Magnani, M. A. Ursitti, R. Acinapura, G. Baldin, M. Capozzi, S. Cicalini, A. Cristaudo, L. Fontanelli Sulekova, G. Iaiani, A. Latini, I. Mastrorosa, M. M. Plazzi, S. Savinelli, A. Vergori, V. Vullo, M. Cecchetto, F. Viviani, P. Bagella, B. Rossetti, A. Franco, R. Fontana Del Vecchio, D. Francisci, C. Di Giuli, P. Caramello, G. C. Orofino, M. Sciandra, M. Bassetti, A. Londero, G. Pellizzer, V. Manfrin, G. Starnini and A. Ialungo

Abstract

Objectives We evaluated the association between pre-ART HIV DNA and HIV-infected participant characteristics at baseline as well as with their response to first-line ART. Methods Four hundred and thirty-three patients from the ICONA cohort, starting first-line ART after the year 2000, were analysed. Pre-ART HIV DNA was quantified with the modified COBAS TaqMan HIV-1 Test and normalized by CD4+ T cells. Linear correlation between pre-ART HIV DNA and other continuous markers (HIV RNA, CD4 count, markers of inflammation and coagulation) at baseline was evaluated by means of Pearson correlation coefficient and a linear regression model. Survival analyses and Cox regression models were used to study the association between pre-ART HIV DNA and time to VIRO-immunoclinical events. Results Pre-ART HIV DNA [median (IQR): 10 \u20ac 702 (3397-36 \u20ac 632) copies/10 6 CD4+ T cells] was correlated with pre-ART HIV RNA [R 2 = +0.44, (P < 0.0001)], CD4+ T cells [R 2 = '0.58, (P < 0.0001)] and CD4/CD8 ratio [R 2 = '0.48, (P < 0.0001)], while weaker correlations were observed with CD8+ T cells (R 2 = '0.20, P = 0.01), IL-6 (R 2 = +0.16, P = 0.002) and soluble CD14 (R 2 = +0.09, P = 0.05). Patients with higher pre-ART HIV DNA showed lower rate and delayed VIROlogical response (defined as HIV RNA 6450 copies/mL), compared with those having lower HIV DNA (67.2% for >10 \u20ac 000, 81.1% for 1000-10 \u20ac 000 and 86.4% for 10-1000 copies/10 6 CD4+ T cells; P = 0.0004). Higher pre-ART HIV DNA was also correlated with increased risk of VIROlogical rebound (defined as HIV RNA >50 copies/mL) by 24 months (17.2% for >10 \u20ac 000, 7.4% for 1000-10 \u20ac 000 and 4.3% for 10-1000 copies/10 6 CD4+ T cells; P = 0.0048). Adjusted HRs of all VIROlogical rebound definitions confirmed these findings (P 64 0.02). Conclusions Pre-ART HIV DNA, along with HIV RNA and CD4+ T cell count, should be considered as a new staging marker to better identify people at lower (or higher) risk of viral rebound following achievement of VIROlogical suppression ( 6450 copies/mL)

Publisher: 'Oxford University Press (OUP)'
Year: 2018
DOI identifier: 10.1093/jac/dky350
OAI identifier: oai:iris.unimore.it:11380/1221098
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • http://hdl.handle.net/11380/12... (external link)
  • Suggested articles


    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.