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Chan School of Public Health","doi-asserted-by":"publisher","award":["P01HD103133 and HD052102"],"award-info":[{"award-number":["P01HD103133 and HD052102"]}],"id":[{"id":"10.13039\/100008548","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007875","name":"Tulane University School of Medicine","doi-asserted-by":"publisher","award":["HD052104"],"award-info":[{"award-number":["HD052104"]}],"id":[{"id":"10.13039\/100007875","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Understanding HIV-1 reservoir dynamics during long-term antiretroviral therapy (ART) in youth with perinatal Human Immunodeficiency Virus Type-1 (HIV-1) is essential for ART-free remission strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We quantified intact and defective HIV proviruses in 201 peripheral blood mononuclear cell samples (PBMCs) from participants ages 17.6\u201321.2 years in the Pediatric HIV\/AIDS Cohort Study (PHACS) Adolescent Master Protocol. Participants were classified as early-suppressed (ES, &amp;lt;1 year of age at virologic suppression [VS]) or late-suppressed (LS, 1\u20135 years of age at VS) and had maintained VS for up to 20 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-six participants (11 ES and 15 LS) were evaluated. Early-suppressed participants exhibited significantly lower intact HIV reservoirs compared with LS participants, with 67% of ES samples below detection limits (2.0 copies\/106 PBMCs). By 5 years of VS, the ES participants had significantly lower mean intact proviral load (2.0 vs 6.6 copies\/106 PBMCs) than LS participants, largely driven by faster clearance of intact proviruses in the first 5 years of VS. Among LS participants, females had larger intact reservoirs than males (mean: 12.5 vs 4.1 intact copies\/106 PBMCs) and exhibited greater increases in defective proviruses over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Achieving VS by 1 year of age in perinatal HIV infection results in substantially smaller HIV intact reservoirs by age 5, with effects sustained through young adulthood. Additionally, sex-based differences, larger intact reservoirs and increases in defective proviruses in females, underscore the need for tailored ART-free remission and cure strategies for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag045","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:16:06Z","timestamp":1769422566000},"page":"e1396-e1406","source":"Crossref","is-referenced-by-count":2,"title":["Dynamics of Intact and Defective Human Immunodeficiency Virus Type 1 (HIV-1) Proviruses During Decades of Suppressive Antiretroviral Treatment in Young Adults With Perinatal HIV"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5688-2071","authenticated-orcid":false,"given":"Priya","family":"Khetan","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0002-681X","authenticated-orcid":false,"given":"Kunjal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, Massachusetts ,","place":["USA"]},{"name":"Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5967-2352","authenticated-orcid":false,"given":"Wendy","family":"Yu","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Szewczyk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adit","family":"Dhummakupt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-9262","authenticated-orcid":false,"given":"Sandra","family":"Burchett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Boston Children's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell B","family":"Van Dyke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Infectious Diseases, Tulane University School of Medicine , New Orleans, Louisiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5195-8743","authenticated-orcid":false,"given":"Deborah","family":"Persaud","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"2026061615193966600_jiag045-B1","author":"UNAIDS"},{"key":"2026061615193966600_jiag045-B2","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1126\/science.278.5341.1295","article-title":"Identification of a reservoir for HIV-1 in patients on highly active antiretroviral therapy","volume":"278","author":"Finzi","year":"1997","journal-title":"Science"},{"key":"2026061615193966600_jiag045-B3","doi-asserted-by":"crossref","first-page":"13193","DOI":"10.1073\/pnas.94.24.13193","article-title":"Presence of an inducible HIV-1 latent reservoir during highly active antiretroviral therapy","volume":"94","author":"Chun","year":"1997","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2026061615193966600_jiag045-B4","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1172\/JCI9006","article-title":"A stable latent reservoir 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