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Brief Report

Association Between Low HIV-1 DNA and Western Blot Reactivity to HIV-1 Pol in Chronically Infected Individuals

Muccini, Camilla MDa; Galli, Laura MScb; Spagnuolo, Vincenzo MDa,b; Poli, Andrea MScb; Rolla, Serena MDc; Mastrangelo, Andrea MDa; Rinaldi, Francesca MDd; Castagna, Antonella MDa,b

JAIDS Journal of Acquired Immune Deficiency Syndromes: December 1, 2019 - Volume 82 - Issue 4 - p 373–376
doi: 10.1097/QAI.0000000000002147
Clinical Science

Background: The aim of the study was to evaluate whether negative HIV-1 pol on Western blot (WB) was associated with low HIV-DNA in adults with chronic HIV-1 infection and suppressive antiretroviral therapy.

Methods: Cross-sectional parent study of the APACHE trial, conducted in subjects with chronic infection, HIV-1 RNA <50 copies/mL for ≥10 years, no residual viremia for ≥5 years and CD4+ >500 cells/µL screened for HIV-1 DNA. HIV-1 DNA was quantified in peripheral blood mononuclear cells (PBMCs) by real-time polymerase chain reaction and HIV-1 serostatus was tested by HIV Blot 2.2 WB assay. Multivariate logistic regression was used to determine factors associated with low HIV-1 DNA.

Results: We evaluated 96 patients: 78 (81%) and 18 (19%) subjects with HIV-1 DNA ≥100 copies/106 PBMCs and with HIV-1 DNA <100 copies/106 PBMCs, respectively. Median age was 32.5 (25.3–38.9), and 61 (64%) were men; moreover, we reported that nadir CD4+ was 253 (167–339) cells/µL and HIV-RNA <50 copies/mL for 11.7 (10.6–14.0) years. At multivariate analysis, higher nadir CD4+ [adjusted odds ratio (AOR) [95% confidence interval (CI) 1.35 (95% CI: 1.03 to 1.76), P = 0.029], longer years of HIV-1 RNA <50 copies/mL [AOR (95% CI) 2.98 (95% CI: 1.25 to 7.10), P = 0.014], a R5-tropic virus [AOR (R5 vs. non-R5) 0.20 (95% CI: 0.04 to 0.96), P = 0.044], and negative HIV-1 pol [AOR 6.59 (95% CI: 1.47 to 29.54), P = 0.014] were associated with low HIV-1 DNA.

Conclusions: In patients with chronic HIV-1 infection and suppressive antiretroviral therapy, negative HIV-1 pol on WB was associated with low HIV-1 DNA as well as higher nadir CD4+, longer years of HIV-1 RNA <50 copies/mL, and a R5-tropic virus.

aVita-Salute San Raffaele University, Milan, Italy;

bDepartment of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy;

cLaboratory of Microbiology and Virology, Department of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy; and

dDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Correspondence to: Camilla Muccini, MD, VIta-Salute San Raffaele University, Via Stamira D'Ancona 20, Milano, 20127, Italy (e-mail:

Supported by internal funding.

Presented in part at the Italian Conference on AIDS and Antiviral Research; June 5–7, 2019; Milan, Italy; Abstract P48.

A.C. has received consultancy payments and speaking fee from Bristol-Myers Squibb, Gilead, ViiV Health Care, Merck Sharp & Dohme, ABBvie, and Janssen-Cilag. The remaining authors have no conflicts of interest to disclose.

C.M. helped to design the study, participated in the analysis of the data, and wrote the manuscript; L.G. analyzed the data and contributed to write the manuscript; A.P. collected clinical and laboratory data; V.S., S.R., A.M., and F.R. contributed to the interpretation of the results and to revise the manuscript; A.C. conceived the study and participated in the analysis of the data. All authors have seen and approved the final version.

Received April 09, 2019

Accepted July 15, 2019

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