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doi:10.1038/nature20583. [FI] to FVI) at ART initiation. Prior to ART initiation, the average CAH burden was 1.4, 4.1, and 3.6 log10 copies/million PBMCs for individuals who initiated ART at FI, FII, and FIII to FVI, respectively. Initiation of ART resulted in a rapid decline of CAH in all individuals, with the greatest decrease being observed in individuals who initiated ART at FI to FIII. By week 60, 100% (FI), 71.8% (FII/FIII), and 20.5% (FIV to FVI) of samples from individuals initiating treatment were at or near the limit of quantitation. Residual CAH was detectable at 60?weeks in most individuals who initiated ART at later stages (FIV to FVI) and averaged 1.9??0.7 log10 copies/million PBMCs. The modified Roche CAP/CTM assay provides a convenient, standardized approach to measure residual HIV in blood and may be useful for monitoring patients under therapy or those participating in HIV remission studies. for 2 min to pellet out the debris. The lysate was tested according to the manufacturers recommendations (Roche CAP/CTM assay package insert). 8E5 cell-spiked whole blood was tested in triplicate for linearity evaluation, and 8E5 cells in 1 PBS were tested in replicates of 10 to evaluate the lower LOD. Clinical specimens. Blood specimens were collected from consenting HIV-1-infected individuals between 18 and 50?years of age who had been on ART therapy for at least 6?months (RV180 protocol; Miriam Hospital, Providence, RI) with undetectable HIV-1 RNA. All subjects were infected with HIV-1 subtype B. Serum samples from all HIV-1-infected individuals were HIV-1/2/O enzyme immunoassay (EIA) repeat reactive and HIV-1 Western blot assay positive (Bio-Rad). Cell pellets were prepared from 0.5?ml of whole blood by lysis of the red blood cells (catalog no. 11814389001; Roche), pelleted by centrifugation at 13,200??for 3 min, and then stored at less than ?70C. Matching frozen whole blood (FWB; 0.2?ml) and cell pellets were selected from 93 HIV-1-infected individuals with no detectable HIV-1 plasma RNA by two HIV-1 viral load assays (the Roche Amplicor HIV-1 Monitor test [v1.5, ultrasensitive; LOD = 50 copies/ml] and the Abbott RealTime HIV-1 test [LOD/LOQ = 40 copies/ml]). The cell pellets and FWB samples selected had been stored for 6 to 10?years at less than ?70C. All samples had previously tested positive for HIV-1 DNA by the Roche Amplicor HIV-1 DNA PCR test, v1.5 (Roche DNA assay), which was used at the time for diagnosis of HIV-1 infection in infants (36, 37) but which is no longer commercially available. An additional 71 specimens from matched HIV-1-uninfected participants aged 18 to 65?years and at risk for HIV infection through either sexual contact or intravenous drug use were used as negative controls. All HIV-1-negative specimens were nonreactive for HIV-1 antibody by the HIV-1/2/O EIA, were negative for plasma HIV-1 RNA, and had values below the Laniquidar cutoff value for the detection of HIV-1 DNA by the Roche Amplicor HIV-1 DNA assay. Additional clinical samples from individuals who initiated ART during acute HIV infection were selected from participants of the RV254/SEARCH010 acute HIV-1 infection study conducted at the Thai Red Cross in Bangkok, Thailand (ClinicalTrials.gov registration no. “type”:”clinical-trial”,”attrs”:”text”:”NCT00796146″,”term_id”:”NCT00796146″NCT00796146) (5, 6, 8, 12). The majority of enrollees were young men who have sex with men and were primarily infected with HIV subtype Laniquidar CRF01_AE. Participants who entered Rabbit Polyclonal to GPR174 the study were classified on the basis of extensive characterization of molecular and serological markers, as follows: individuals classified as Fiebig stage I had detectable HIV-1 RNA only (Hologic Aptima HIV-1 RNA qualitative test) with quantitative HIV-1 RNA viral load results (Roche Cobas AmpliPrep/Cobas TaqMan HIV-1 test); those classified as Fiebig stage II were reactive by the HIV-1 p24 Ag test (RUO; Bio-Rad) or Architect HIV Ag/Ab Combo test (Abbott) but nonreactive for HIV-1 antibody by the HIV-1/2/O EIA (Bio-Rad GS HIV-1/HIV-2 Plus O EIA); and those classified as Fiebig stage III, IV, V, and VI were all HIV-1/2/O EIA antibody reactive and differentiated by Bio-Rad GS HIV-1 Western blot analysis as negative, indeterminate, positive with no p31 antigen reactivity, and positive with p31 detection, respectively (6). Laniquidar All study participants were offered immediate antiviral treatment (tenofovir, lamivudine or emtricitabine, and efavirenz) with appropriate substitutions for any participants with baseline resistance or intolerance. PBMCs from a total of 37 participants were selected based upon the Fiebig classification at the time of ART initiation: 9 participants were classified as FI, 6 participants were classified as FII, 7 participants were.