Qualitative plasma viral load determination as a tool for screening of viral reservoir size in PWH

Thessa Laeremans, Sigrid D'haese, Jonathan Aernout, Kurt Barbé, Pieter Pannus, Sofie Rutsaert, Ellen Vancutsem, Guido Vanham, Coca Necsoi, Ward De Spiegelaere, Marie Couttenye, Natacha Herssens, Marie-Angélique De Scheerder, Stéphane De Wit, Linos Vandekerckhove, Eric Florence, Joeri L Aerts, Sabine D Allard

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Suppression of viral replication in patients on antiretroviral therapy (ART) is determined by plasma viral load (pVL) measurement. Whenever pVL reaches values below the limit of quantification, the qualitative parameter 'target detected' or 'target not detected' is available but often not reported to the clinician. We investigated whether qualitative pVL measurements can be used to estimate the viral reservoir size.

DESIGN: The study recruited 114 people with HIV (PWH) who are stable on ART between 2016 and 2018. The percentage of pVL measurements qualitatively reported as 'target detected' (PTD) within a 2-year period was calculated.

METHODS: t-DNA and US-RNA were used to estimate viral reservoir size and were quantified on peripheral blood mononuclear cells (PBMCs) using droplet digital PCR.

RESULTS: A median of 6.5 pVL measurements over a 2-year period was evaluated for each participant to calculate PTD. A positive correlation was found between t-DNA and PTD (r = 0.24; P = 0.011) but not between US-RNA and PTD (r = 0.1; P = 0.3). A significantly lower PTD was observed in PWH with a small viral reservoir, as estimated by t-DNA less than 66 copies/106 PBMCs and US-RNA less than 10 copies/106 PBMCs, compared with PWH with a larger viral reservoir (P = 0.001). We also show that t-DNA is detectable whenever PTD is higher than 56% and that ART regimen does not affect PTD.

CONCLUSION: Our study shows that PTD provides an efficient parameter to preselect participants with a small viral reservoir based on already available pVL data for future HIV cure trials.

Original languageEnglish
Pages (from-to)1761-1768
Number of pages8
JournalAIDS
Volume36
Issue number13
DOIs
Publication statusPublished - 1 Nov 2022

Bibliographical note

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Keywords

  • DNA, Viral/analysis
  • HIV Infections/drug therapy
  • Humans
  • Leukocytes, Mononuclear
  • Plasma/chemistry
  • RNA
  • RNA, Viral
  • Viral Load

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