Control of HIV-1 RNA load after HAART interruption: Relationship with CCR5 co-receptor density and proviral DNA load in HIV-infected patients

Abstract

Background CCR5 co-receptor density has been reported to play a role in the level of HIV production. In addition, reports about the relationship between proviral DNA load and plasma HIV load are controversial. Objectives To analyse the role of CCR5 co-receptor density and proviral DNA load in the control of plasma HIV-viral load after HAART interruption, comparing patients whose plasma HIV load was persistently below 4 log 10 RNA copies/mL, defined as “HIV controllers”, with patients who showed a viral load higher than 4 log 10 RNA copies/mL, defined as “non-controllers”. Study design Proviral DNA load quantification ( N = 55) and CCR5 co-receptor density ( N = 29) were determined in HIV-infected patients on prolonged HAART interruption. Results Twenty-three percent of our HAART interruption cohort were classified as HIV controllers, while 77% were classified as non-controllers. CCR5 co-receptor density was statistically higher in HIV controllers than in non-controllers, while proviral DNA load was not different between them. CCR5 co-receptor density in activated CD4 cells was independently associated with HIV plasma load after interruption. Conclusions The observation of a higher CCR5 co-receptor expression in HIV controllers suggests that HIV infection leads to the selection of CD4 cells with low CCR5 co-receptor density after HAART interruption.