Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant

Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant

Deborah Persaud, M.D., Hannah Gay, M.D., Carrie Ziemniak, M.S., Ya Hui Chen, B.A., Michael Piatak, Ph.D., Tae-Wook Chun, Ph.D., Matthew Strain, M.D., Ph.D., Douglas Richman, M.D., and Katherine Luzuriaga, M.D.

October 23, 2013DOI: 10.1056/NEJMoa1302976

An infant born to a woman with human immunodeficiency virus type 1 (HIV-1) infection began receiving antiretroviral therapy (ART) 30 hours after birth owing to high-risk exposure. ART was continued when detection of HIV-1 DNA and RNA on repeat testing met the standard diagnostic criteria for infection. After therapy was discontinued (when the child was 18 months of age), levels of plasma HIV-1 RNA, proviral DNA in peripheral-blood mononuclear cells, and HIV-1 antibodies, as assessed by means of clinical assays, remained undetectable in the child through 30 months of age. This case suggests that very early ART in infants may alter the establishment and long-term persistence of HIV-1 infection.

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