To the Editor: Discontinuation of combined
antiretroviral therapy (CART) improves virological control and specific immunity
in some persons infected with human immunodeficiency virus 1 (HIV-1),1 whereas in others it results in rapid viral rebound
and decrease in the antiviral cytotoxic T cell responses below the pretherapeutic
level.2 The host factors responsible for
these opposite consequences are largely unknown. We have recently reported
that the mean number of CCR5 coreceptors at the surface of CD4 T cells (CCR5
density) is logarithmically correlated with viral load3 and
disease progression4 during HIV-1 infection.
We have explained this link by showing in vitro that CCR5 density strongly
determines the efficiency of HIV-1 life cycle, particularly at the reverse
transcription stage.5 Herein we report a
test of the hypothesis that CCR5 density, which is stable over time in a given
individual but varies among individuals, might determine the intensity of
viral rebound after cessation of CART.
Reynes J, Baillat V, Portales P, Clot J, Corbeau P. Relationship Between CCR5 Density and Viral Load After Discontinuation of Antiretroviral Therapy. JAMA. 2004;291(1):46. doi:10.1001/jama.291.1.46