Determinants of HIV-1 reservoir size and long-term dynamics during suppressive ART.

Bachmann, Nadine; von Siebenthal, Chantal; Vongrad, Valentina; Turk, Teja; Neumann, Kathrin; Beerenwinkel, Niko; Bogojeska, Jasmina; Fellay, Jaques; Roth, Volker; Kok, Yik Lim; Thorball, Christian W; Borghesi, Alessandro; Parbhoo, Sonali; Wieser, Mario; Böni, Jürg; Perreau, Matthieu; Klimkait, Thomas; Yerly, Sabine; Battegay, Manuel; Rauch, Andri; ... (2019). Determinants of HIV-1 reservoir size and long-term dynamics during suppressive ART. Nature communications, 10(1), pp. 1-11. Nature Publishing Group 10.1038/s41467-019-10884-9

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The HIV-1 reservoir is the major hurdle to a cure. We here evaluate viral and host characteristics associated with reservoir size and long-term dynamics in 1,057 individuals on suppressive antiretroviral therapy for a median of 5.4 years. At the population level, the reservoir decreases with diminishing differences over time, but increases in 26.6% of individuals. Viral blips and low-level viremia are significantly associated with slower reservoir decay. Initiation of ART within the first year of infection, pretreatment viral load, and ethnicity affect reservoir size, but less so long-term dynamics. Viral blips and low-level viremia are thus relevant for reservoir and cure studies.

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