SHIV remission in macaques with early treatment initiation and ultra long-lasting antiviral activity
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Studies in SIV-infected macaques have shown that the virus reservoir is particularly refractory to conventional suppressive antiretroviral therapy (ART). We posited that optimized ART regimens designed to have robust penetration in tissue reservoirs and provide long-lasting antiviral activity may be advantageous for HIV or SIV remission. Macaques infected with RT-SHIV received oral emtricitabine/tenofovir alafenamide and long-acting cabotegravir and rilpivirine without (n=4) or with (n=4) the immune activator vesatolimod after the initial onset of viremia. All animals were fully suppressed during treatment (4-12 months) and showed no virus rebound during a follow up period of 1.5-2 years despite CD8+ T cell depletion. We show efficient multidrug penetration in virus reservoirs and persisting rilpivirine in plasma for 2 years after the last dose. Our results document a new type of virus remission that is achieved through early treatment initiation and provision of ultra long-lasting antiviral activity that persists after treatment cessation.
