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The following is a summary of “Factors influencing virologic control during analytical treatment interruptions in HIV cure trials – a pooled analysis of individual level data,” published in the March 2025 issue of Journal of Infectious Diseases by Klastrup et al. 

A primary objective in human immunodeficiency virus (HIV) cure research continues to be the attainment of ART-free virologic control.  

Researchers conducted a retrospective study to identify factors linked to time to detectable viremia and loss of virologic control through a pooled analysis of 6 interventional trials involving analytical antiretroviral therapy (ART) interruption.  

They analyzed factors affecting time to detectable viremia (plasma HIV-RNA ≥50 copies/mL) and loss of virologic control (2 consecutive plasma HIV-RNA measurements ≥5,000 copies/mLor ART restart) using Cox proportional hazard regression.  

The results showed that among 91 participants, total HIV-DNA ≥750 copies and intact proviral DNA ≥80 copies/10⁶ cluster of differentiation CD4+ T cells were linked to a shorter time to detectable viremia (HR=1.98, 95% confidence interval [CI]: 1.22, 3.22; HR=1.67, 95% CI: 1.08, 2.58, respectively). Total HIV-DNA ≥750 copies/10⁶ CD4+ T cells also correlated with a shorter time to loss of virologic control (HR=1.64, 95% CI: 1.01, 2.67), as did a delay of ≥1 year from HIV diagnosis to ART initiation (HR=1.56, 95% CI: 1.02, 2.39). Use of histone deacetylase inhibitors was associated with a shorter time to loss of virologic control (HR=2.22, 95% CI: 1.12, 4.41) while broadly neutralizing anti-HIV-1 antibody (bNAb) treatment at ART initiation in individuals harboring 3BNC117-sensitive viruses showed a trend toward delayed virologic control loss (HR=0.32, 95% CI: 0.10, 1.01).  

Investigators concluded that early ART initiation and low HIV reservoirs positively influenced the time to viral rebound during analytical treatment interruption. 

Source: academic.oup.com/jid/advance-article-abstract/doi/10.1093/infdis/jiaf163/8096499