Author Affiliations: Medical Research Council, Clinical Trials Unit, London, United Kingdom (Dr Porter); Instituto de Salud Carlos III, Centro Nacional de Epidemiologia, Madrid, Spain (Dr Lodi); and University Paris Sud, INSERM CESP U1018, Assistance Publique–Hôpitaux de Paris, le Kremlin Bicetre, Paris, France (Dr Meyer).
Hocqueloux et al propose that longer duration of combined antiretroviral therapy (cART) in primary human immunodeficiency virus (HIV) infection (PHI) is associated with a higher probability of creating posttreatment controllers (PTCs). They cite as evidence the superior proportion of PTCs in their study compared with ours (15.6% vs 5.5%), as well as a number of studies that would support their hypothesis.1- 5 While longer duration of cART administered during PHI may lead to a higher proportion of individuals controlling viral replication on its withdrawal, a hypothesis not supported by their own study or the ANRS (Agence Nationale de Recherche sur le Sida) CO6 PRIMO study by Goujard et al,3 studies differ by a number of factors other than treatment duration. Therefore, inference about the effect of cART duration from raw figures derived from published studies is inappropriate. In any case, it is erroneous to state that there were no PTCs in the SPARTAC (Short Pulse Anti Retroviral Therapy at HIV Seroconversion) study, which could not be deduced from the citation provided.5
Porter K, Lodi S, Meyer L. Immunovirologic Control 24 Months After Interruption of Antiretroviral Therapy Initiated Close to HIV Seroconversion—Reply. JAMA Intern Med. 2013;173(6):475-477. doi:10.1001/jamainternmed.2013.2784