Cillo, Anthony R.Krishnan, SupriyaMcMahon, Deborah K.Mitsuyasu, Ronald T.Para, Michael F.Mellors, John W.2014-04-112014Cillo, Anthony R., Supriya Krishnan, Deborah K. McMahon, Ronald T. Mitsuyasu, Michael F. Para, and John W. Mellors. 2014. “Impact of Chemotherapy for HIV-1 Related Lymphoma on Residual Viremia and Cellular HIV-1 DNA in Patients on Suppressive Antiretroviral Therapy.” PLoS ONE 9 (3): e92118. doi:10.1371/journal.pone.0092118. http://dx.doi.org/10.1371/journal.pone.0092118.1932-6203http://nrs.harvard.edu/urn-3:HUL.InstRepos:12064402The first cure of HIV-1 infection was achieved through complex, multimodal therapy including myeloablative chemotherapy, total body irradiation, anti-thymocyte globulin, and allogeneic stem cell transplantation with a CCR5 delta32 homozygous donor. The contributions of each component of this therapy to HIV-1 eradication are unclear. To assess the impact of cytotoxic chemotherapy alone on HIV-1 persistence, we longitudinally evaluated low-level plasma viremia and HIV-1 DNA in PBMC from patients in the ACTG A5001/ALLRT cohort on suppressive antiretroviral therapy (ART) who underwent chemotherapy for HIV-1 related lymphoma without interrupting ART. Plasma HIV-1 RNA, total HIV-1 DNA and 2-LTR circles (2-LTRs) in PBMC were measured using sensitive qPCR assays. In the 9 patients who received moderately intensive chemotherapy for HIV-1 related lymphoma with uninterrupted ART, low-level plasma HIV-1 RNA did not change significantly with chemotherapy: median HIV-1 RNA was 1 copy/mL (interquartile range: 1.0 to 20) pre-chemotherapy versus 4 copies/mL (interquartile range: 1.0 to 7.0) post-chemotherapy. HIV-1 DNA levels also did not change significantly, with median pre-chemotherapy HIV-1 DNA of 355 copies/106 CD4+ cells versus 228 copies/106 CD4+ cells post-chemotherapy. 2-LTRs were detectable in 2 of 9 patients pre-chemotherapy and in 3 of 9 patients post-chemotherapy. In summary, moderately intensive chemotherapy for HIV-1 related lymphoma in the context of continuous ART did not have a prolonged impact on HIV-1 persistence. Clinical Trials Registration Unique Identifier: NCT00001137en-USBiology and life sciencesImmunologyClinical immunologyHIV immunopathogenesisMicrobiologyMedical MicrobiologyMicrobial PathogensViral PathogensImmunodeficiency VirusesHIVVirologyViruses and CancerMedicine and health sciencesDiagnostic medicineHIV diagnosis and managementHematologyHematologic Cancers and Related DisordersLymphomasInfectious DiseasesViral DiseasesOncologyCancers and NeoplasmsCancer TreatmentJournal Article2014-04-1110.1371/journal.pone.0092118