IUPMInfectious Units per Million cells
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These studies have included the addition of agents, such as enfuvirtide, additional protease inhibitors (ritonavir-boosted atazanavir or lopinavir) or raltegravir, to an already suppressive regimen Disappointingly, none of these studies have demonstrated any decline in low-level viraemia, IUPM or cell-associated HIV DNA.
They observed an increase in HIV RNA (measured by the single copy assay) and 2-LTR circles in association with a significant decrease in the IUPM. This is the only intervention to date that has shown a decrease in the number of latently infected cells (measured by IUPM) using intensification in patients on suppressive cART.
A recent study of a patient treated with suppressive cART during primary infection had extremely low levels of IUPM for prolonged periods of time; however, disappointingly viral rebound still occurred in this patient following cessation of cART Therefore, eventually we will need to consider whether cART interruption is an appropriate clinical end point of these studies given the well documented risks of reactivation of viral replication.