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January 7, 2004

Relationship Between CCR5 Density and Viral Load After Discontinuation of Antiretroviral Therapy

JAMA. 2004;291(1):46. doi:10.1001/jama.291.1.46

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.

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