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Post-treatment and spontaneous HIV control

Martin, Genevieve E.a; Frater, Johna,b

doi: 10.1097/COH.0000000000000488
PROGRESS IN ACHIEVING LONG-TERM HIV REMISSION: Edited by Jean-Daniel Lelièvre and Timothy J. Henrich

Purpose of review The aim of the current review is to explore the evidence around virological remission in ART-treated and untreated individuals living with HIV. With increasing evidence and interest in post-treatment control within the HIV-cure field, it is now increasingly important to agree on definitions to allow different ‘controller’ phenotypes to be clearly distinguished and mechanisms compared.

Recent findings This review explores recent data on potential predictors and mechanisms driving spontaneous and post-treatment control. We explore data on the role of the reservoir as a determinant of control and the challenges associated with its study, including the safety of treatment interruption. We explore options around deriving a consensus on how to define different forms of control and the longer term utility of achieving remission.

Summary Post-treatment control and remission following treatment interruption are becoming increasingly common measures of intervention efficacy in cure trials. As well as a need to show treatment interruption protocols are well tolerated and acceptable, for these measures to be robust and comparable between studies, clear and consensual definitions need to be agreed.

aNuffield Department of Medicine, Peter Medawar Building for Pathogen Research

bOxford National Institute of Health Research Biomedical Research Centre, Oxford, UK

Correspondence to John Frater, FRCP, PhD, Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, Oxford, UK. E-mail: john.frater@ndm.ox.ac.uk

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