Intensification and stimulation therapy for human immunodeficiency virus type 1 reservoirs in infected persons receiving virally suppressive highly active antiretroviral …

J Kulkosky, G Nunnari, M Otero… - The Journal of …, 2002 - academic.oup.com
J Kulkosky, G Nunnari, M Otero, S Calarota, G Dornadula, H Zhang, A Malin, J Sullivan, Y Xu…
The Journal of infectious diseases, 2002academic.oup.com
Highly active antiretroviral therapy (HAART) has led to significant changes in mortality and
morbidity in the human immunodeficiency virus type 1 (HIV-1) epidemic. Nevertheless,
because of molecular mechanisms of viral persistence, HAART does not eradicate HIV-1.
Didanosine and hydroxyurea were added to the antiretroviral regimens of 3 HIV-1–infected
men who were receiving stable HAART and who had HIV-1 RNA levels< 50 copies/mL at
the initiation of the study protocol, as a novel intensification to attack cryptic viral replication; …
Abstract
Highly active antiretroviral therapy (HAART) has led to significant changes in mortality and morbidity in the human immunodeficiency virus type 1 (HIV-1) epidemic. Nevertheless, because of molecular mechanisms of viral persistence, HAART does not eradicate HIV-1. Didanosine and hydroxyurea were added to the antiretroviral regimens of 3 HIV-1–infected men who were receiving stable HAART and who had HIV-1 RNA levels <50 copies/mL at the initiation of the study protocol, as a novel intensification to attack cryptic viral replication; low-dose OKT3 was then administered, followed by a course of interleukin-2, to stimulate latent provirus. Replication-competent virus was undetectable after treatment, and plasma viral RNA was either undetectable or <5 copies/mL. In trial periods during which no antiretroviral therapy was administered, the patients developed plasma viral rebound. This translational approach combines novel intensification and stimulation therapy to deplete residual HIV-1 reservoirs. Additional experimental approaches must be developed if HIV-1 eradication is to become possible in patients receiving virally suppressive HAART
Oxford University Press