Studies Shed Light on Rare Group of Patients With HIV

A pair of new studies is shedding light on a rare, but scientifically important, group of people with HIV who are able to maintain viral control even after stopping antiretroviral therapy.

A pair of new studies is shedding light on a rare, but scientifically important, group of people with HIV who are able to maintain viral control even after stopping antiretroviral therapy. Clues about this ability may help improve antiretroviral therapy, which currently most patients with HIV must receive for life.

These patients are known as post-treatment controllers (PTCs). They are defined as people who have viral loads of 400 or fewer copies per milliliter of blood plasma at least 24 weeks after cessation of therapy.

A recent study looked at 67 post-treatment controllers in an attempt to locate any similarities or correlations that might suggest which patients are likely to become PTCs. The researchers found that in the majority (n = 38) of cases in which a patient became a PTC, the patient started ART soon after infection. Of the 67 patients, just over half—55%—maintained viral control at 2 years. About 1 in 5 still had viral suppression at 5 years.

Lead author Jonathan Z. Li, MD, of Brigham and Women's Hospital's Infectious Disease Clinic, told

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that early treatment appears to be an important factor in determining the odds that a patient will be a post-treatment controller.

“[I]n addition to the individual and public health benefits of early antiretroviral therapy initiation, we’ve now found that it increases the chances of sustained HIV remission,” he said. “Waiting to start ART will decrease their chances of becoming a post-treatment controller.”

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