HIV RNA/DNA Levels at Diagnosis Can Predict Immune Reconstitution: A Longitudinal Analysis

Author:

Basoulis Dimitrios1ORCID,Pantazis Nikos2ORCID,Paraskevis Dimitrios2ORCID,Iliopoulos Panos2,Papadopoulou Martha1,Akinosoglou Karolina3ORCID,Hatzakis Angelos2,Daikos George L.1,Psichogiou Mina1ORCID

Affiliation:

1. 1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece

2. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece

3. Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Medical School, University of Patras, 26504 Patras, Greece

Abstract

Background: HIV DNA mirrors the number of infected cells and the size of the HIV viral reservoir. The aim of this study was to evaluate the effect of pre-cART HIV DNA levels as a predictive marker of immune reconstitution and on the post-cART CD4 counts trends. Methods: HIV DNA was isolated from PBMCs and quantified by real-time PCR. Immune reconstitution was assessed up to four years. Piecewise-linear mixed models were used to describe CD4 count changes. Results: 148 people living with HIV (PLWH) were included. The highest rate of immune reconstitution was observed during the first trimester. There was a trend showing that high HIV RNA level resulted in greater increase in CD4 count, especially during the first trimester of cART (difference above vs. below median 15.1 cells/μL/month; 95% CI −1.4–31.5; p = 0.073). Likewise, higher HIV DNA level would predict greater CD4 increases, especially after the first trimester (difference above vs. below median 1.2 cells/μL/month; 95% CI −0.1–2.6; p = 0.071). Higher DNA and RNA levels combined were significantly associated with greater CD4 increase past the first trimester (difference high/high vs. low/low 2.1 cells/μL/month; 95% CI 0.3–4.0; p = 0.024). In multivariable analysis, lower baseline CD4 counts predicted a greater CD4 rise. Conclusions: In successfully treated PLWH, pre-cART HIV DNA and HIV RNA levels are predictors of immune reconstitution.

Funder

Gilead Sciences International through the VOICE program

Publisher

MDPI AG

Subject

Virology,Microbiology (medical),Microbiology

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