Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies
Abstract The only current strategy to test efficacy of novel interventions for sustained HIV control without antiretroviral therapy (ART) among people with HIV (PWH) is through an analytical treatment interruption (ATI). Inclusion of ‘placebo’ controls in ATIs poses ethical, logistical, and economic...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41467-025-56116-1 |
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| author | Jesper D. Gunst Jesal Gohil Johanthan Z. Li Ronald J. Bosch Andrea White, Catherine Seamon Tae-Wook Chun Beatriz Mothe Kathleen Gittens Lauren Praiss Marie-Angélique De Scheerder Linos Vandekerckhove Kevin Escandón Ann Thorkelson Timothy Schacker Devi SenGupta Christian Brander Emmanouil Papasavvas Luis J. Montaner Javier Martinez-Picado Ruxandra Calin Antonella Castagna Camilla Muccini Wesley de Jong Lorna Leal Felipe Garcia Rob A. Gruters Timothy Tipoe John Frater Ole S. Søgaard Sarah Fidler |
| author_facet | Jesper D. Gunst Jesal Gohil Johanthan Z. Li Ronald J. Bosch Andrea White, Catherine Seamon Tae-Wook Chun Beatriz Mothe Kathleen Gittens Lauren Praiss Marie-Angélique De Scheerder Linos Vandekerckhove Kevin Escandón Ann Thorkelson Timothy Schacker Devi SenGupta Christian Brander Emmanouil Papasavvas Luis J. Montaner Javier Martinez-Picado Ruxandra Calin Antonella Castagna Camilla Muccini Wesley de Jong Lorna Leal Felipe Garcia Rob A. Gruters Timothy Tipoe John Frater Ole S. Søgaard Sarah Fidler |
| author_sort | Jesper D. Gunst |
| collection | DOAJ |
| description | Abstract The only current strategy to test efficacy of novel interventions for sustained HIV control without antiretroviral therapy (ART) among people with HIV (PWH) is through an analytical treatment interruption (ATI). Inclusion of ‘placebo’ controls in ATIs poses ethical, logistical, and economic challenges. To understand viral dynamics and rates of post-treatment control (PTC) after ATI among PWH receiving either placebo or no intervention, we undertook an individual-participant data meta-analysis. In total, 24 eligible prospective studies with 382 individuals with ≥5 plasma HIV RNA viral loads (pVLs) within the first 84 days post-ATI were included. Early-ART was defined as ART initiation within 6 months of HIV acquisition; others were classified as late-ART or unknown. Median age was 42 years, 91% male, 75% white, 45% received early-ART. Median time to pVL >50, >400, and >10,000 copies/mL was 16 days (interquartile range [IQR]:13–25), 21 (IQR:15–28), and 32 (IQR:20–35), respectively. PTC defined as pVL <50 copies/mL at day 84 occurred in 4% (n = 14) of participants (6% early-ART and 1% late-ART). Sustained PTC of pVL <50 copies/ml after 84 days is rare in PWH, especially in those starting ART late. Our findings inform future interventional HIV cure/remission trials on study size and design. |
| format | Article |
| id | doaj-art-5f9f778bf57f41fb8a0d588a9b6dc7f7 |
| institution | Kabale University |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Nature Communications |
| spelling | doaj-art-5f9f778bf57f41fb8a0d588a9b6dc7f72025-01-26T12:42:16ZengNature PortfolioNature Communications2041-17232025-01-0116111310.1038/s41467-025-56116-1Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studiesJesper D. Gunst0Jesal Gohil1Johanthan Z. Li2Ronald J. Bosch3Andrea White, Catherine Seamon4Tae-Wook Chun5Beatriz Mothe6Kathleen Gittens7Lauren Praiss8Marie-Angélique De Scheerder9Linos Vandekerckhove10Kevin Escandón11Ann Thorkelson12Timothy Schacker13Devi SenGupta14Christian Brander15Emmanouil Papasavvas16Luis J. Montaner17Javier Martinez-Picado18Ruxandra Calin19Antonella Castagna20Camilla Muccini21Wesley de Jong22Lorna Leal23Felipe Garcia24Rob A. Gruters25Timothy Tipoe26John Frater27Ole S. Søgaard28Sarah Fidler29Department of Infectious Diseases, Aarhus University HospitalDepartment of Infectious Disease Imperial College London, Imperial College NIHR BRCBrigham and Women’s Hospital, Harvard Medical SchoolHarvard T.H. Chan School of Public HealthCritical Care Medicine Department, Clinical Center, National Institutes of HealthLaboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of HealthIrsiCaixa Immunopathology Research InstituteClinical Center, National Institutes of HealthLaboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of HealthDepartment of General Internal Medicine, Ghent University HospitalHIV Cure Research Center, Department of General Internal Medicine, Ghent University Hospital, Ghent UniversityDivision of Infectious Diseases and International Medicine, Department of Medicine, University of MinnesotaDepartment of Medicine, University of MinnesotaDivision of Infectious Diseases and International Medicine, Department of Medicine, University of MinnesotaGilead Sciences, IncIrsiCaixa Immunopathology Research InstituteThe Wistar InstituteThe Wistar InstituteIrsiCaixa Immunopathology Research InstituteDepartment of Infectious Diseases, Tenon Hospital, Sorbonne University, AP-HPInfectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific InstituteInfectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific InstituteDepartment of Viroscience, Erasmus MCInfectious Diseases Department, Hospital Clínic BarcelonaInfectious Diseases Department, Hospital Clínic BarcelonaDepartment of Viroscience, Erasmus MCNuffield Dept of Medicine, University of Oxford, UK and NIHR Oxford Biomedical Research CentreNuffield Dept of Medicine, University of Oxford, UK and NIHR Oxford Biomedical Research CentreDepartment of Infectious Diseases, Aarhus University HospitalDepartment of Infectious Disease Imperial College London, Imperial College NIHR BRCAbstract The only current strategy to test efficacy of novel interventions for sustained HIV control without antiretroviral therapy (ART) among people with HIV (PWH) is through an analytical treatment interruption (ATI). Inclusion of ‘placebo’ controls in ATIs poses ethical, logistical, and economic challenges. To understand viral dynamics and rates of post-treatment control (PTC) after ATI among PWH receiving either placebo or no intervention, we undertook an individual-participant data meta-analysis. In total, 24 eligible prospective studies with 382 individuals with ≥5 plasma HIV RNA viral loads (pVLs) within the first 84 days post-ATI were included. Early-ART was defined as ART initiation within 6 months of HIV acquisition; others were classified as late-ART or unknown. Median age was 42 years, 91% male, 75% white, 45% received early-ART. Median time to pVL >50, >400, and >10,000 copies/mL was 16 days (interquartile range [IQR]:13–25), 21 (IQR:15–28), and 32 (IQR:20–35), respectively. PTC defined as pVL <50 copies/mL at day 84 occurred in 4% (n = 14) of participants (6% early-ART and 1% late-ART). Sustained PTC of pVL <50 copies/ml after 84 days is rare in PWH, especially in those starting ART late. Our findings inform future interventional HIV cure/remission trials on study size and design.https://doi.org/10.1038/s41467-025-56116-1 |
| spellingShingle | Jesper D. Gunst Jesal Gohil Johanthan Z. Li Ronald J. Bosch Andrea White, Catherine Seamon Tae-Wook Chun Beatriz Mothe Kathleen Gittens Lauren Praiss Marie-Angélique De Scheerder Linos Vandekerckhove Kevin Escandón Ann Thorkelson Timothy Schacker Devi SenGupta Christian Brander Emmanouil Papasavvas Luis J. Montaner Javier Martinez-Picado Ruxandra Calin Antonella Castagna Camilla Muccini Wesley de Jong Lorna Leal Felipe Garcia Rob A. Gruters Timothy Tipoe John Frater Ole S. Søgaard Sarah Fidler Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies Nature Communications |
| title | Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies |
| title_full | Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies |
| title_fullStr | Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies |
| title_full_unstemmed | Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies |
| title_short | Time to HIV viral rebound and frequency of post-treatment control after analytical interruption of antiretroviral therapy: an individual data-based meta-analysis of 24 prospective studies |
| title_sort | time to hiv viral rebound and frequency of post treatment control after analytical interruption of antiretroviral therapy an individual data based meta analysis of 24 prospective studies |
| url | https://doi.org/10.1038/s41467-025-56116-1 |
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