Early Antiretroviral Therapy During Primary HIV-1 Infection Results in a Transient Reduction of the Viral Setpoint upon Treatment Interruption

Background: Long-term benefits of combination antiretroviral therapy (cART) initiation during primary HIV-1 infection are debated. Methods: The evolution of plasma HIV-RNA (432 measurements) and cell-associated HIV-DNA (325 measurements) after cessation of cART (median exposure 18 months) was described for 33 participants from the Zurich Primary HIV Infection Study using linear regression and compared with 545 measurements from 79 untreated controls with clinically diagnosed primary HIV infection, respectively a known date for seroconversion. Results: On average, early treated individuals were followed for 37 months (median) after cART cessation; controls had 34 months of pre-cART follow-up. HIV-RNA levels one year after cART interruption were 20.8 log10 copies/mL [95 % confidence interval 21.2;20.4] lower in early treated patients compared with controls, but this difference was no longer statistically significant by year three of follow-up (20.3 [20.9; 0.3]). Mean HIV-DNA levels rebounded from 2 log10 copies [1.8; 2.3] o