PMID- 28719012
OWN - NLM
STAT- MEDLINE
DCOM- 20180529
LR  - 20220216
IS  - 1468-1293 (Electronic)
IS  - 1464-2662 (Linking)
VI  - 18
IP  - 10
DP  - 2017 Nov
TI  - The impact of immunoglobulin in acute HIV infection on the HIV reservoir: a 
      randomized controlled trial.
PG  - 777-781
LID - 10.1111/hiv.12524 [doi]
AB  - OBJECTIVES: Antiretroviral therapy (ART) during acute HIV infection (AHI) 
      restricts the HIV reservoir, but additional interventions are necessary to induce 
      a cure. Intravenous immunoglobulin (IVIG) is not HIV-specific but is safe and 
      temporarily reduces the HIV reservoir in chronic HIV infection. We present a 
      randomized controlled trial to investigate whether IVIG plus ART in AHI reduces 
      the HIV reservoir and immune activation compared with ART alone. METHODS: Ten men 
      with AHI (Fiebig II-IV) initiated ART (tenofovir, entricitabine, ritonavir 
      boosted darunavir and raltegravir) at HIV-1 diagnosis and were randomized to ART 
      alone or ART plus 5 days of IVIG, once virally suppressed (week 19). Blood 
      samples were evaluated for viral reservoir, immune activation, immune exhaustion 
      and microbial translocation. Flexible sigmoidoscopy was performed at weeks 19, 24 
      and 48, and gut proviral DNA and cell numbers determined. RESULTS: IVIG was well 
      tolerated and no viral blips (> 50 HIV-1 RNA copies/mL) occurred during IVIG 
      therapy. From baseline to week 48, total HIV DNA in peripheral blood mononuclear 
      cells (PBMCs) (cases: -3.7 log(10) copies/10(6) CD4 cells; controls: -3.87 
      log(10) copies/10(6) CD4 cells) declined with no differences observed between the 
      groups (P = 0.49). Declines were observed in both groups from week 19 to week 48 
      in total HIV DNA in PBMCs (P = 0.38), serum low copy RNA (P = 0.57) and gut total 
      HIV DNA (P = 0.55), but again there were no significant differences between arms. 
      Biomarkers of immune activation, immune exhaustion and microbial translocation 
      and the CD4:CD8 ratio were similar between arms for all comparisons. CONCLUSIONS: 
      Although safe, IVIG in AHI did not impact total HIV DNA, immune function or 
      microbial translocation in peripheral blood or gut tissue.
CI  - (c) 2017 British HIV Association.
FAU - Tiraboschi, J
AU  - Tiraboschi J
AD  - Guys and St Thomas' NHS Foundation Trust, London, UK.
FAU - Ray, S
AU  - Ray S
AD  - Guys and St Thomas' NHS Foundation Trust, London, UK.
FAU - Patel, K
AU  - Patel K
AD  - Guys and St Thomas' NHS Foundation Trust, London, UK.
FAU - Teague, A
AU  - Teague A
AD  - Guys and St Thomas' NHS Foundation Trust, London, UK.
FAU - Pace, M
AU  - Pace M
AD  - University of Oxford, Oxford, UK.
FAU - Phalora, P
AU  - Phalora P
AD  - University of Oxford, Oxford, UK.
FAU - Robinson, N
AU  - Robinson N
AD  - University of Oxford, Oxford, UK.
FAU - Hopkins, E
AU  - Hopkins E
AD  - University of Oxford, Oxford, UK.
FAU - Meyerowitz, J
AU  - Meyerowitz J
AD  - University of Oxford, Oxford, UK.
FAU - Wang, Y
AU  - Wang Y
AD  - Division of Health and Social Care Research, King's College London, London, UK.
FAU - Cason, J
AU  - Cason J
AD  - Department of Infectious Diseases, Kings College London, London, UK.
FAU - Kaye, S
AU  - Kaye S
AD  - Oxford National Institute of Health, Oxford, UK.
FAU - Sanderson, J
AU  - Sanderson J
AD  - Guys and St Thomas' NHS Foundation Trust, London, UK.
FAU - Klenerman, P
AU  - Klenerman P
AD  - University of Oxford, Oxford, UK.
FAU - Fidler, S
AU  - Fidler S
AD  - Imperial College London, London, UK.
FAU - Frater, J
AU  - Frater J
AD  - University of Oxford, Oxford, UK.
AD  - Oxford National Institute of Health Research Biomedical Research Centre, Oxford, 
      UK.
FAU - Fox, J
AU  - Fox J
AD  - Guys and St Thomas' NHS Foundation Trust, London, UK.
LA  - eng
GR  - 109965/Z/15/Z/WT_/Wellcome Trust/United Kingdom
GR  - MR/L006588/1/MRC_/Medical Research Council/United Kingdom
GR  - MR/P011233/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20170718
PL  - England
TA  - HIV Med
JT  - HIV medicine
JID - 100897392
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (DNA, Viral)
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adult
MH  - Anti-Retroviral Agents/therapeutic use
MH  - Bacterial Translocation
MH  - DNA, Viral/blood
MH  - Drug Therapy, Combination/methods
MH  - HIV Infections/*drug therapy
MH  - HIV-1/*isolation & purification
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Male
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Viral Load
OTO - NOTNLM
OT  - HIV reservoir
OT  - acute HIV infection
OT  - immunoglobulin
EDAT- 2017/07/19 06:00
MHDA- 2018/05/31 06:00
CRDT- 2017/07/19 06:00
PHST- 2017/04/12 00:00 [accepted]
PHST- 2017/07/19 06:00 [pubmed]
PHST- 2018/05/31 06:00 [medline]
PHST- 2017/07/19 06:00 [entrez]
AID - 10.1111/hiv.12524 [doi]
PST - ppublish
SO  - HIV Med. 2017 Nov;18(10):777-781. doi: 10.1111/hiv.12524. Epub 2017 Jul 18.