HIV‐1 DNA decay is faster in children who initiate ART shortly after birth than later

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dc.contributor.authorVeldsman, Kirsten A.en_ZA
dc.contributor.authorJanse van Rensburg, Anitaen_ZA
dc.contributor.authorIsaacs, Shahiedaen_ZA
dc.contributor.authorNaidoo, Shalenaen_ZA
dc.contributor.authorLaughton, Barbaraen_ZA
dc.contributor.authorLombard, Carlen_ZA
dc.contributor.authorCotton, Mark F.en_ZA
dc.contributor.authorMellors, John W.en_ZA
dc.contributor.authorvan Zyl, Gert U.en_ZA
dc.date.accessioned2021-10-07T09:46:58Zen_ZA
dc.date.available2021-10-07T09:46:58Zen_ZA
dc.date.issued2019-08en_ZA
dc.descriptionCITATION: Veldsman, K. A. et al. 2019. HIV-1 DNA decay is faster in children who initiate ART shortly after birth than later. Journal of the International AIDS Society, 22(8). doi:10.1002/jia2.25368en_ZA
dc.descriptionThe original publication is available at https://onlinelibrary.wiley.com/journal/17582652en_ZA
dc.description.abstractIntroduction: There is limited data in children on whether persistence of HIV‐1 infected cells is affected by age at initiating antiretroviral therapy (ART), its duration or any subsequent ART interruption. We therefore investigated the effects of both age of ART initiation and duration of ART interruption on HIV‐1 DNA decay in children. Methods: We investigated HIV‐1 DNA decay in three groups of children on ART: Group‐1 (n = 7) started uninterrupted ART within eight days of life; Group‐2 (n = 8) started uninterrupted ART at a median of five months of age; and Group‐3 (n = 23) started ART at a median age of 1.8 months for either 40 or 96 weeks, then interrupted ART (median of seven months), and restarted ART based on CD4 count and clinical criteria. Total HIV‐1 DNA was assayed using a sensitive HIV‐1 subtype C‐adapted quantitative PCR for integrase. The duration of ART was square root transformed to fit the observed slowing of HIV‐1 DNA decay rate. For each group, point estimates for decay rates were determined after six months of continuous suppressive ART in groups 1 and 2 or six months after restarting ART in Group‐3. Groups‐2 and 3 were combined using a mixed effect regression model to investigate covariates of HIV‐1 DNA decay rate. Results and Discussion: At six months of continuous suppressive ART, the HIV‐1 DNA t½ (95% CI) was shorter in Group‐1 (n = 7): 2.7 months (2.1 to 3.8), than 9.2 months (7.4 to 12.1) in Group‐2 (n = 8); and 9.6 months (7.6 to 12.6) in Group‐3 (n = 23) (p < 0.01). In multivariable analyses, HIV‐1 DNA before treatment (p < 0.001) and the change in HIV‐1 DNA during interruption (p < 0.01) were independent predictors of slower HIV‐1 DNA decay. Conclusions: These data suggest that ART initiation within the first week of life can reduce the persistence of long‐lived infected cells. Delaying ART is associated with slower decay of infected cells.en_ZA
dc.description.urihttps://onlinelibrary.wiley.com/doi/10.1002/jia2.25368en_ZA
dc.description.versionPublisher’s versionen_ZA
dc.format.extent7 pagesen_ZA
dc.identifier.citationVeldsman, K. A. et al. 2019. HIV-1 DNA decay is faster in children who initiate ART shortly after birth than later. Journal of the International AIDS Society, 22(8). doi:10.1002/jia2.25368en_ZA
dc.identifier.issn1758-2652 (online)en_ZA
dc.identifier.otherdoi:10.1002/jia2.25368en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/123166en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherInternational AIDS Societyen_ZA
dc.rights.holderAuthors retain rightsen_ZA
dc.subjectCommunicable diseases in infants -- Africaen_ZA
dc.subjectHIV infections -- Treatment -- Africaen_ZA
dc.subjectHIV infections -- Diagnosis -- Africaen_ZA
dc.subjectPediatrics -- Africaen_ZA
dc.subjectDNA antibodiesen_ZA
dc.titleHIV‐1 DNA decay is faster in children who initiate ART shortly after birth than lateren_ZA
dc.typeArticleen_ZA
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