Paradoxically Greater Persistence of HIV RNA-Positive Cells in Lymphoid Tissue When ART Is Initiated in the Earliest Stage of Infection

Eugène Kroon, Suthat Chottanapund, Supranee Buranapraditkun, Carlo Sacdalan, Donn J. Colby, Nitiya Chomchey, Peeriya Prueksakaew, Suteeraporn Pinyakorn, Rapee Trichavaroj, Sandhya Vasan, Sopark Manasnayakorn, Cavan S Reilly, Erika Helgeson, Jodi L Anderson, Caitlin David, Jacob Zulk, Mark de Souza, Sodsai Tovanabutra, Alexandra Schuetz, Merlin L. RobbDaniel C. Douek, Nittaya Phanuphak, Ashley Haase, Jintanat Ananworanich, Timothy W. Schacker

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Starting antiretroviral therapy (ART) in Fiebig 1 acute HIV infection limits the size of viral reservoirs in lymphoid tissues, but does not impact time to virus rebound during a treatment interruption. To better understand why the reduced reservoir size did not increase the time to rebound we measured the frequency and location of HIV RNA+ cells in lymph nodes from participants in the RV254 acute infection cohort. HIV RNA+ cells were detected more frequently and in greater numbers when ART was initiated in Fiebig 1 compared to later Fiebig stages and were localized to the T-cell zone compared to the B-cell follicle with treatment in later Fiebig stages. Variability of virus production in people treated during acute infection suggests that the balance between virus-producing cells and the immune response to clear infected cells rapidly evolves during the earliest stages of infection. Clinical Trials Registration: NCT02919306.

Original languageEnglish (US)
Pages (from-to)2167-2175
Number of pages9
JournalJournal of Infectious Diseases
Issue number12
StatePublished - Jun 15 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America.


  • HIV reservoir
  • acute HIV infection
  • antiretroviral therapy
  • in situ hybridization
  • lymphoid tissues


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