Abstract
Analysis of changes in viral load after initiation of treatment with potent antiretroviral agents has provided substantial insight into the dynamics of human immunodeficiency virus type 1 (HIV-1)1–3. The concentration of HIV-1 in plasma drops by ∼99% in the first two weeks of treatment owing to the rapid elimination of free virus with a half-life (t1/2) of ≤6 hours and loss of productively infected cells with a t1/2 of 1.6 days3. Here we show that with combination therapy this initial decrease is followed by a slower second-phase decay of plasma viraemia. Detailed mathematical analysis shows that the loss of long-lived infected cells (t1/2of1–4weeks) is a major contributor to the second phase, whereas the activation of latently infected lymphocytes (t1/2 of 0.5–2 weeks) is only a minor source. Based on these decay characteristics, we estimate that 2.3–3.1 years of a completely inhibitory treatment would be required to eliminate HIV-1 from these compartments. To eradicate HIV-1 completely, even longer treatment may be needed because of the possible existence of undetected viral compartments or sanctuary sites.
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Perelson, A., Essunger, P., Cao, Y. et al. Decay characteristics of HIV-1-infected compartments during combination therapy. Nature 387, 188–191 (1997). https://doi.org/10.1038/387188a0
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DOI: https://doi.org/10.1038/387188a0
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