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However, the long-term impact of this intervention remains unclear. We measured the frequency of inducible, translation-competent, and replication-competent proviruses in samples from 62 children who initiated ART early and remained virally suppressed for up to 9.9 years. Only a small fraction of HIV genomes produced HIV transcripts, viral proteins, or infectious virions. Accordingly, replication-competent virus was detected in only 11% of the participants. Despite the predominance of naive cells in pediatric blood, most proviruses were detected in memory CD4\n                    <jats:sup>+<\/jats:sup>\n                    T cells, especially central memory cells. Longitudinal analysis revealed a biphasic decay in HIV DNA: an initial decline followed by long-term stability, which was associated with extensive expansions of infected T cell clones. In contrast, inducible proviruses declined continuously and became undetectable in most children after 5 years. Near full-length sequencing of 1,305 HIV genomes revealed a dramatic reduction in genetically intact proviruses, from pre-ART to after 7 years of ART. Together, these findings suggest that the intact viral reservoir rapidly decays in early-treated children, offering critical insights for pediatric HIV cure strategies.\n                  <\/jats:p>","DOI":"10.1172\/jci198054","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:00:52Z","timestamp":1775145652000},"source":"Crossref","is-referenced-by-count":1,"title":["Rapid and profound decay of inducible and intact HIV genomes in early-treated Thai children"],"prefix":"10.1172","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-151X","authenticated-orcid":true,"given":"Marta","family":"Massanella","sequence":"first","affiliation":[{"name":"Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-5853","authenticated-orcid":true,"given":"Caroline","family":"Dufour","sequence":"additional","affiliation":[{"name":"Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Pagliuzza","sequence":"additional","affiliation":[{"name":"Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audr\u00e9e","family":"Lemieux","sequence":"additional","affiliation":[{"name":"Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corentin","family":"Richard","sequence":"additional","affiliation":[{"name":"Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1369-3224","authenticated-orcid":true,"given":"Jintanat","family":"Ananworanich","sequence":"additional","affiliation":[{"name":"Department of Global Health, Amsterdam Medical Center, University of Amsterdam, Amsterdam, Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Leyre","sequence":"additional","affiliation":[{"name":"Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thidarat","family":"Jupimai","sequence":"additional","affiliation":[{"name":"Center of Excellence in Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-4318","authenticated-orcid":true,"given":"Supranee","family":"Buranapraditkun","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Thai Red Cross Society, Bangkok, Thailand."},{"name":"Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI);"},{"name":"Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center-Chula VRC); 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