Cellular proviral HIV-DNA decline and viral isolation in naive subjects with <5000 copies/ml of HIV-RNA and > 500 x 106/l CD4 cells treated with highly active antiretroviral therapy

Massimo Andreoni, Saverio G. Parisi, Loredana Sarmati, Emanuele Nicastri, Lucia Ercoli, Giorgio Mancino, Giovanni Sotgiu, Marco Mannazzu, Marco Trevenzoli, Giuseppe Tridente, Ercole Concia, Antonio Aceti

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the decay rate of cellular proviral HIV-DNA and viral replication in patients receiving highly active antiretroviral therapy (HAART) in the very early phase of infection. Methods: Thirty-four patients treated with HAART and retrospectively selected for progressive decline of plasma viraemia up to undetectable levels (<20 copies/ml), were stratified according to CD4+ cell count and plasma viraemia at base line: > 500 x 106 cells/l with <5000 copies/ml (group 1) or with > 5000 copies/ml (group 2), > 5000 copies/ml with 300-500 x 106 cells/l (group 3) or with <300 x 106 cells/l (group 4). Plasma HIV-RNA and proviral HIV-DNA were analysed at baseline and after 1, 2, 3, 6, 9 and 12 months of treatment. Results: After 1 year of treatment, a significant decrease of proviral DNA titre was observed in all patients and a decrease > 1 log was achieved in 24 of 29 subjects of the first three groups. The more pronounced decay of HIV-DNA (half-life 28 weeks) up to <50 HIV-DNA copies/106 CD4+ cells was detected in patients of group 1. At the year's endpoint, five patients (four in group 1 and one in group 2) had <20 HIV-DNA copies. However, HIV strains sensitive to antiretroviral drugs were isolated from peripheral lymphocytes of 16 out of 34 patients. Conclusion: In patients with undetectable plasma viraemia after 1 year of HAART, the highest reduction of proviral DNA up to <50 copies/106 CD4+ cells was obtained only in subjects in the early asymptomatic phase of infection. Nevertheless, a replication-competent virus can be detected in all phases of antiretroviral therapy. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish
Pages (from-to)23-29
Number of pages7
JournalAIDS (London, England)
Issue number1
Publication statusPublished - 2000


  • Early treatment of HIV-infection
  • Highly active antiretroviral therapy
  • HIV isolation
  • Proviral HIV-DNA

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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