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This phenomenon has been separately associated to both low levels of HIV\u20101 proviral DNA as well as cell\u2010associated RNA. We investigated whether the combination of both parameters could help predict delayed viral rebound after treatment interruption (TI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an open single\u2010arm ATI study in four Belgian HIV reference centres from January 2016 to July 2018. Eligible participants were adults who had fewer than 50 HIV\u20101 RNA copies\/mL for more than two years, more than 500 CD4 cells\/\u00b5L for more than three months, and were in general good health. Consenting participants who had fewer than 66 copies total HIV\u20101 DNA (t\u2010DNA) and fewer than 10 copies cell\u2010associated HIV\u20101 unspliced RNA (US\u2010RNA) per million peripheral blood mononuclear cells (PBMCs), interrupted therapy and were monitored closely. Antiretroviral therapy (ART) was resumed after two consecutive viral loads exceeding 1000 copies or one exceeding 10,000 copies\/mL. The primary outcome was the proportion of participants with fewer than 50 HIV\u20101 RNA copies\/mL 48\u00a0weeks after TI. Secondary outcomes were time to viral rebound, the frequency of serious adverse events (AEs) and evolution of t\u2010DNA and US\u2010RNA after TI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 16 consenting participants who interrupted therapy experienced rapid viral rebound two to eight weeks after TI. No serious AEs were observed. Levels of t\u2010DNA and US\u2010RNA increased after TI but returned to pre\u2010ATI levels after treatment restart. None of the studied demographic, clinical and biological parameters were predictive of time of viral rebound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of low levels of t\u2010DNA and US\u2010RNA in PBMCs, corresponding respectively to a small and transcriptionally silent viral reservoir, is not predictive of viral remission after TI in patients on ART.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25453","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T02:58:56Z","timestamp":1582858736000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Rapid viral rebound after analytical treatment interruption in patients with very small HIV reservoir and minimal on\u2010going viral 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