Journal of Acquired Immune Deficiency Syndrome, August 2019
Although ART suppresses plasma viremia to levels below the level of detection, reservoirs of latently infected cells that lead to viral rebound if ART is stopped persist in people living with HIV. One measure of the latently infected cell population in people on ART is cell-associated HIV DNA, which is comprised of intact and defective proviruses. Authors examined more than 100 individuals on long-term ART in the ACTG HIV Reservoirs Cohort (AHRC) from A5321 and A5001. The study found that HIV antibody levels declined significantly the longer individuals remained on ART and correlated with HIV-specific T cell responses. The study also found that despite many years of therapy (during which plasma HIV RNA was consistently suppressed), HIV antibody and HIV-specific T cell responses correlated with HIV DNA levels, suggesting that the immune system is sensing, but not clearing, infected cells, likely due to persistent immune dysfunction.