Association of HIV neutralizing antibody with lower viral load after treatment interruption in a prospective trial (A5170)


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Abstract

Objective:We investigated the impact of neutralizing antibodies (NAbs) on CD4 T-cell count and viral load in a cohort of HAART recipients who underwent extended structured treatment interruption.Design:Substudy of NAb in the AIDS Clinical Trials Group 5170 trial.Methods:Early plasma samples from 50 volunteers who discontinued HAART were evaluated in a peripheral blood mononuclear cell-based neutralization assay against a panel of four subtype B primary isolates.Results:We found that high-titer (90% inhibitory dose > 500) NAb against two or more isolates was associated with reduced viral load (P = 0.003 at 12-week posttreatment interruption). This effect faded with time, losing significance (P = 0.161) by study conclusion. Participants possessing the highest NAb levels against individual isolates appeared more likely to have lower viral loads with the association gaining significance against the R5-tropic primary isolate US1 (P = 0.005). There was no association between broader neutralization and CD4 T-cell slope over time.Conclusion:The data suggest that high-titer NAb responses at the time of treatment interruption are associated with reduced viral load over time, but not CD4+ T-cell decline.

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