Uncovering an Early Marker for HIV Reactivation
By Jeffrey Laurence, M.D.
HIV-positive individuals involved in cure studies typically agree to stop antiretroviral therapy (ART) as part of an analytic treatment interruption (ATI) so that scientists can gauge the efficacy of a particular intervention. Identification of markers predictive of HIV reactivation following interruption of ART would be of enormous benefit to HIV cure research.
Identification of markers predictive of HIV reactivation following interruption of ART would be of enormous benefit to HIV cure research.amfAR-funded researchers and their colleagues studied 23 individuals from five different clinical trials that included an ATI component. Changes in a subset of CD4+ T cells in the blood—those carrying a surface protein known as CD30, a marker of certain activated T cells—were measured starting two weeks after interruption of ART. The frequency of cells containing the CD30 marker increased almost twofold in three-quarters of the 23 individuals. These changes preceded detection of the virus itself and, in some cases, occurred up to a month before clinically apparent HIV rebound.
There are valid concerns about the safety of interrupting ART, given the uncertain risks of viral rebound. This study found that CD30 may provide a tool both for accessing important research information—using biopsies or scans to identify those parts of the body from which the virus first reappears—and to permit restarting ART before HIV becomes detectable in the blood.
Researchers involved with this study are affiliated with the amfAR Institute for HIV Cure Research.
Dr. Laurence is amfAR’s senior scientific consultant.