Early ART Can Reduce Total HIV DNA

Receiving early ART associated with a 316-fold decrease in HIV DNA after 3 years.

Early intervention with antiretroviral therapy (ART) can drastically reduce total HIV DNA levels in the body, which could potentially improve HIV remission, a recent study found.

Researchers hope these findings can lead to a HIV vaccine in the future. Since inactive HIV can remain in the body in a reservoir, it can become active again, regardless of previous treatment that eradicated the active virus.

“HIV reservoir size is pertinent to the goal of HIV remission - that is, undetectable viral load without treatment - because the size of the reservoir may predict time to viral load rebound after ART cessation,” said researcher Jintanat Ananworanic, MD, PhD. “It is hypothesized that people with a smaller reservoir size will have a greater chance of achieving HIV remission.”

In a study published by EBioMedicine, researchers compared the HIV DNA of patients who received early treatment with ART with the HIV DNA of patients who received treatment later. The researchers measured the amount of HIV DNA in the blood, and used that as a measurement of HIV reservoir size.

Researchers discovered that patients who started ART early had a significantly reduced reservoir size. Without ART, HIV DNA peaked early, and created a set level within the first 6 weeks of infection, according to the study.

After 2 weeks, ART reduced total HIV DNA in the blood by 20-fold. It was decreased 316-fold after 3 years, the researchers reported.

“This would indicate that, currently, the most effective way to significantly lower the HIV reservoir size is with very early treatment,” said researcher Merlin Robb, MD. “Identifying timing of HIV DNA set point will inform when to intervene.”