ART in early infection stops further viral evolution
21 April 2024. Related: Antiretrovirals, Virology.
Simon Collins, HIV i-Base
Given the focus on analysing the viral reservoir as a central part on HIV cure-related research, a recent study is helpful for supporting an outcome of ART that is still under-appreciated by many people living with HIV. [1]
This is that effective ART doesn’t slow the virus down, but stops it from evolving. Getting an undetectable viral load freezes the HIV in time, even after many years of treatment.
Without ART, HIV doesn’t just replicate to produce increasing levels of virus in our bodies, but it is also evolving and changing – and also becoming more diverse. But even after years on ART, our viral reservoir is the HIV that we had when we first started treatment,
This was reported about 20 years ago, and in increasing detail by many different research groups since. [2, 3, 4]
The current paper from Sook-Kyung Lee and colleagues is based on analysing whole-genome viral sequences of replicant-competent HIV from ten people who had been on effective ART within two months of acute infection. It was published on 17 April 2024 in Open Forum Infectious Diseases.
References
- Lee S-K et al. Sequence Analysis of Inducible, Replication-Competent Virus Reveals No Evidence of HIV-1 Evolution During Suppressive Antiviral Therapy Indicating A Lack Of Ongoing Viral Replication, Open Forum Infectious Diseases, 2024, ofae212, https://doi.org/10.1093/ofid/ofae212
- Tobin NL, Frenkel L et al. Evidence that low-level viremias during effective HAART result from two processes: expression of archival virus and replication of virus. J Virology, Aug. 2005, p. 9625-9634.
http://jvi.asm.org/cgi/content/abstract/79/15/9625 - Lack of virological impact of treatment intensification in suppressed patients supports latent viral reservoir as source of residual viraemia, HTB (August 2008).
https://i-base.info/htb/596 - No HIV evolution in plasma or lymph nodes on suppressive ART and no impact from further intensification. HTB (March 2018).
https://i-base.info/htb/33616