Effect Of TwHF On Viral Reservoir And Immune Activation In Primary HIV Infection

BACKGROUND AND PURPOSE:The introduction of HAART has dramatically changed patients’ control over the HIV virus.However,due to the presence of an early established HIV reservoir,current treatment has not been able to eradicate the virus from our system.Evidence is accumulating for the dependent relationship between the immue activation caused by HIV infection and HIV reservoir.For patients with primary HIV infection,the effect of early use of intense antiretroviral therapy and TwHF on the immune activation and reservoir is under investigation.Changes in serum inflammation markers and virus reservoir levels were investigated to compare the effect of intense therapy and TwHF on primary HIV infection patients.METHODS:Patients with primary HIV infection are enrolled in our single-centered study.The treatment arms are divided as standard therapy arm,intense therapy arm(Standard therapy+integrase inhibitor),and the TwHF therapy arm.Patients in the TwHF arm received ART to begin with and oral TwHF was later added week 24th to 72nd.All immune activation and HIV reservoir levels were assessed at week 24th,48th,72n,and 96th.The main endpoints were changes in serum inflammation markers and peripheral viral reservoirs.RESULTS:A total of 28 patients were enrolled(9 in standard arm,11 in intense arm,and 8 in TwHF arm).A decrease in the level of IP-10 and TNF-a was observed in intensive and TwHF arms.The TNF-a level in TwHF arm showed significant difference from baseline(P=0.008,0.029,0.019 respectively,for week 24th,48th,and 720,).Significant intergroup diffenrece was observed among three arms on week 48th and 72n(P=0.019,0.034 respectively).More recepients with low IP-10 level were found in TwHF arm than intense therapy arm(75%vs33.3%,75%vs22.2%respectively).HIV reservoir declined significantly after intense treatment.Difference among arms was observed at week 72nd and 96th(P =0.034,0.038*respectively).CONCLUSION:TwHF shows efficacy in suppressing levels of serum inflammatory markers in primary infection of HIV,which suggests its potential nature of reining the abnormal immune activation in HIV patients.Intense therapy during the early phase of HIV infection is related to a decline in peripheral HIV reservoir.A relationship between TwHF therapy and dynamic changes of virus reservoir is also observed.