Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission
Authors: Chéret Antoine , Bacchus-Souffan Charline , Avettand-Fenoël Veronique , Mélard Adeline , Nembot Georges , Blanc Catherine , Samri Assia , Sáez-Cirión Asier , Hocqueloux Laurent , Lascoux-Combe Caroline , Allavena Clotilde , Goujard Cécile , Valantin Marc Antoine , Leplatois Anne , Meyer Laurence , Rouzioux Christine , Autran Brigitte ,   on behalf of the OPTIPRIM ANRS-147 Study Group, Hoen B. , Bourdeaux C. , Delfraissy J. F. , Goujard C. , Amri I. , Fourn E. , Quertainmont Y. , Môle M. , Rami A. , Durel A. , Diemer M. , Parrinello M. , Allègre T. , Lafeuillade A. , Hittinger G. , Lambry V. , Carrerre M. , Philip G. , Duvivier C. , Consigny P. H. , Charlier C. , Shoai M. , Touam F. , Pialoux G. , Slama L. , L'Yavanc T. , Mathurin P. , Adda A. , Berrebi V. , Salmon D. , Chakvetadze E. , Tassadit T. , Ousseima E. , Pietri M. P. , Levy Y. , Lascaux A. S. , Lelievre J. D. , Giovanna M. , Dominguez S. , Dumont C. , Katlama C. , Valentin M. A. , Seang S. , Schneider L. , Kiorza N. , Chermak A. , Ben Abdallah S. , Simon A. , Pichon F. , Pauchard M. , Molina J. M. , Lascoux C. , Ponscarme D. , Colin De Verdiere N. , Scemla A. , De Castro N. , Rachline A. , Garrait V. , Rozenbaum W. , Ferret S. , Balkan S. , Clavel F. , Tourdjman M. , Lafaurie M. , Aslan A. , Goguel J. , Thierry S. M. , De Lastours V. , Gallien S. , Pavie J. , Delgado J. , Mededji C. , Veron R. , Abel S. , Pierre-François S. , Baringhton C. , Chennebault J. M. , Vandamme Y. M. , Fialaire P. , Rehaiem S. , Rabier V. , Abgueguen P. , Morlat P. , Vandenhende M. A. , Bernard N. , Lacoste D. , Michaux C. , Paccalin F. , Receveur M. C. , Caldato S. , Delaune J. , Ragnaud J. M. , Neau D. , Lacaze-Buzy L. , Livrozet J. M. , Jeanblanc F. , Makhloufi D. , Brunel Dalmas F. , Jourdain J. J. , Chiarello P. , Yeni P. , Phung B. , Rioux C. , Godard C. , Louni F. , El Alami Talbi N. , Catalano G. , Guiroy F. , Reynes J. , Jacquet J. M. , Fauchere V. , Merle C. , Lemoine V. , Loriette M. , Morquin D. , Makinson A. , Atoui N. , Tramoni C. , Raffi F. , Allavena C. , Bonnet B. , Bouchez S. , Feuillebois N. , Brunet-François C. , Reliquet V. , Mounoury O. , Morineau-Le-Houssine P. , Billaud E. , Brosseau D. , Hüe H. , Dellamonica P. , Vassallo M. , Leplatois A. , Durant J. , Naqvi A. , Joulié A. , Souala F. , Michelet C. , Arvieux C. , Tattevin P. , Leroy H. , Revest M. , Fily F. , Chapplain J. M. , Ratajczak C. M. , Gras G. , Bernard L. , Dailloux J. F. , Laplantine V. , Cuzin L. , Marchou B. , Larrigue S. , Chauveau M. , Balsarin F. , Obadia M. , Chéret A. , Bonne S. , Huleux T. , Ajana F. , Alcaraz I. , Baclet V. , Melliez H. , Viget N. , De La Tribonniere X. , Aissi E. , Poissy J. , Ravaux I. , Vallon A. , Varan M. , May T. , Letranchant L. , Burty C. , Briaud A. , Wassoumbou S. , Stenzel M. , Bouillon M. P. , Debab Y. , Caron F. , Gueit I. , Chapuzet C. , Borsa Lebas F. , Etienne M. , Miailhes P. , Perpoint T. , Senechal A. , Schlienger I. , Cotte L. , Augustin Normand C. , Boibieux A. , Ferry T. , Corsini N. , Braun E. , Lippran J. , Biron F. , Chidiac C. , Pailhes S. , Lipman J. , Braun E. , Koffi J. , Thoirain V. , Brochier C. , Greder Belan A. , Therby A. , Monnier S. , Ruquet M. , Garrait V. , Richier L. , Prevoteau Du Clary F. , Philibert P. , Chapus C. , Cabié A. , Abel S. 
Published: February 2017

AbstractBackgroundTherapeutic control of HIV replication reduces the size of the viral reservoir, particularly among central memory CD4+ T cells, and this effect might be accentuated by early treatment.MethodsWe examined the effect of ART initiated at the time of the primary HIV infection (early ART), lasting 2 and 6 years in 11 and 10 patients, respectively, on the HIV reservoir in peripheral resting CD4+ T cells, sorted into naive (TN), central memory (TCM), transitional memory (TTM) and effector memory (TEM) cells, by comparison with 11 post-treatment controllers (PTCs).ResultsBetween baseline and 2 years, CD4+ T cell subset numbers increased markedly (P &lt; 0.004) and HIV DNA levels decreased in all subsets (P &lt; 0.009). TTM cells represented the majority of reservoir cells at both timepoints, T cell activation status normalized and viral diversity remained stable over time. The HIV reservoir was smaller after 6 years of early ART than after 2 years (P &lt; 0.019), and did not differ between PTCs and patients treated for 6 years. One patient, who had low reservoir levels in all T cell subsets after 2 years of treatment similar to the levels in PTCs, spontaneously controlled viral replication during 18 months off treatment.ConclusionsEarly prolonged ART thus limits the size of the HIV reservoir, protects long-lived cells from persistent infection and may enhance post-treatment control.