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The Body Covers: The 8th Conference on Retroviruses and Opportunistic Infections
Viral Dynamics and Reservoirs

February 6, 2001

  • Viral Reservoirs after Two Years of Sustained Serum Viral Suppression in Patients in whom HAART Was Initiated Early: The Merck 060/ICC 004 Cohort (Poster 395)
    Authored by T.-W. Chun, D. McMahon, J. S. Justement, B. Sha, C. Carpenter, D. Goodwin, J. Pientka, M. Seniuk, R. Leavitt, A. Meibohm, and M. Robertson
    View the original abstract

The dream of eradicating virus from latent reservoirs has been the impetus for a number of recent studies, including Merck 060 which enrolled 199 naive adults with CD4 cell counts above 500 and viral loads above 1000 copies. All patients received AZT/3TC and indinavir at standard doses.

Sixteen patients who had sustained viral suppression defined as viral load below 50 copies for at least 96 consecutive weeks were eligible for the viral reservoir sub-study. The sub-study was planned to evaluate virus in lymph node tissue, genital secretions and CSF. Patients were further screened for clearance of virus from blood by quantitative microcultures of PBMC. Four of 16 had positive cultures, and were not eligible for further study. Of the remaining 12, five have undergone leukapheresis for high-input co-culture of resting CD4 cells and HIV could not be cultured from two; results from the other seven patients are pending. The two patients with no detectable replication-competent virus cultured from resting CD4 cells will now undergo evaluation of various tissue compartments.

Although these are the most positive data recently presented in the search for the holy grail of viral eradication, the number of patients who have made it this far is extremely small. Theoretically, it will be important to demonstrate whether eradication is possible at all, even if it is achievable only in rare circumstances. Further results from the study will be eagerly awaited.

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