The Significance Of Intracellular HIV-1 RNA Detection In The Evaluation Of AIDS Treatment Effect And Disease Monitoring

Background:Cells that can retain their ability to replicate HIV DNA on the genome during long-term antiretroviral therapy after being infected with HIV are called HIV reservoir cells,and are currently the main obstacle for HIV cure or functional cure.In recent years,researchers have developed new treatment strategy "kick and kill”and drugs to achieve the cure of HIV.The detection of HIV reservoir is a very important part of this.However,there is no convenient,economical,and reproducible means of measuring HIV reservoirs yet.CA HIV-1 RNA is used to detect unspliced HIV RNA in cells.This marker is transcribed by integrated HIV DNA,and decreases simultaneously with HIV-1 DNA during ART treatment.It can significantly increase along with the use of drugs such as HDACis,and has an important relationship with the progression of HIV disease and the reactivation of the HIV reservoirs.It is widely regarded as a sign of so called "active reservoir" and an important technique used in related studies.Purpose:This study aims to explore the application of CA HIV-1 RNA in the evaluation of ART treatment effect and disease monitoringMethods:After verifying the stability and reproducibility of the kits used in this study,11 patients initiating ART treatment during chronic phase in Peking Union Medical College Hospital from January 2012 to June 2020 were included.Frozen PBMC specimens from the beginning of antiviral treatment till the first-year follow-up year were selected.After cell recovery,selected specimens at baseline,1-month,3-month,6-month,9-month,and 12-month follow-up were tested for CA HIV-1 RNA and total HIV DNA.Other laboratory tests of these patient were used for combined analysis.Result:1.The CA HIV-1 RNA test results are comparable to the results reported in the current literature.The baseline viral load of 11 patients was 5.2±0.5 log10copies/mL,and the CD4+T cell count was 242±94/mm3.The average CA HIV-1 RNA level was 4.1±0.8 log,ocopies/106PBMC,and the baseline HIV-1 DNA level was 3.4±0.4 log10 copies/106PBMC.2.After one year of ART treatment,the plasma HIV RNA load of all patients fell below the lower limit of detection.The average CD4+T cell count was 458±169 cells/mm3 during one year of follow-up,which was significantly higher than the baseline level(p<0.05).The average CA HIV-1 RNA was 3.9±1.0 log10cells/106PBMC,and there was no significant difference compared with the baseline level(p=0.7303).The average HIV-1 DNA was 3.1±0.6 log10cells/106PBMC,which was included in this study There were no significant differences among patients compared with baseline levels(p=0.2380).3.Among 8 out of 11 patients,CA HIV-1 RNA and HIV-1 DNA showed strong correlation.4.The patients were divided into two groups A and B according to the decline of HIV DNA level within one year of treatment,and the laboratory test results of the two groups were compared.CA HIV-1 RNA and other laboratory tests were not significantly different.Conclusion:CA HIV-1 RNA test is relatively reliable clinical test and has certain clinical value in monitoring HIV infection.