To explore the impact of early versus late antiretroviral therapy (ART) on HIV reservoirs in children with perinatal HIV infection and to inform strategies for achieving HIV cure.
Key Findings:
Children who received early ART had lower levels of intact proviral DNA compared to those who received late ART.
Two-thirds of early ART participants had undetectable intact proviruses, while only 11% to 31% of late ART participants had similar results.
The decline in intact proviral DNA was more rapid in early ART recipients during the first five years.
Interpretation:
The findings suggest that early initiation of ART may lead to smaller HIV reservoirs, potentially facilitating ART-free remission and informing future cure strategies.
Limitations:
Limited sample size and number of samples during the initial years of ART.
Challenges in procuring large numbers of cells from infants for analysis.
Conclusion:
Early ART is associated with lower intact proviral DNA levels, which is crucial for developing effective HIV cure strategies in children.
