oing an analytic treatment interruption . A total of 110 participants underwent a 16-week ATI after randomization in a 2:1 ratio to receive MedChemExpress 10083-24-6 either three doses of vaccine or placebo. The vaccine induced significant CD4 and CD8 HIV-1 Gag-specific T-cell responses in a subset of participants and marginally significant decreases in the level of viremia during the analytic treatment interruption. Vaccination was associated with lower ATI viral load even after controlling for viral and host genetic factors. In addition, the magnitude of detectable HIV-1 Gagspecific CD4 IFN-c-producing cells was negatively correlated with viral load set point. The goals of this analysis were to characterize study participants with initial virologic suppression, evaluate viral and immunologic correlates of such a response, and determine the durability of virologic control 49 weeks after treatment interruption. HLA Typing HLA class I typing was performed following the sequence-specific oligonucleotide probing and sequence-based typing protocols recommended by the 13th International Histocompatibility Workshop. Protective HLA alleles were defined a priori as HLA B13, B27, B51, B57, and B5801. Unfavorable HLA alleles were defined as the HLA-B35-Px variants . The protective HLA group includes all individuals with at least one protective HLA allele. Those without a protective HLA allele, but with at least one unfavorable HLA allele were categorized in the unfavorable HLA group. Participants ” with neither 15256538” protective nor unfavorable HLA alleles were categorized in the neutral HLA group. Intracellular Cytokine Staining Assays and Flow Cytometric Analysis Cell-mediated immune responses at study weeks 0, 8, and 38 were evaluated by an intracellular cytokine staining assay for interferon-gamma, tumor necrosis factor-alpha, and interleukin-2 as previously described. Peripheral blood lymphocytes were first exposed to a Gag peptide pool for 18 hours. CD4 and CD8 T cells producing cytokines and expressing cytotoxic T lymphocyte antigen 4 or programmed death-1 were detected by multiparameter flow cytometry. A “positive change”in the numbers of CD4 or CD8 IFN-c-producing T cells in response to Gag stimulation was defined as at least a two-fold increase from baseline to week 38. Viral sequencing from Plasma and Sequence Analysis. Most participants had plasma viral sequences analyzed at three time points: at the time of initial detectable viremia, ATI week 16, and ATI week 49. The Gag and reverse transcriptase coding sequences were amplified from plasma HIV-1 RNA by nested RT-PCR using gene-specific primers. Population sequencing was performed on an ABI 3730 automated DNA sequencer. Chromatograms were analyzed using Sequencher. We calculated the number of amino acid mismatches between the vaccine or consensus HIV-1 subtype B sequence and the patient-derived sequence. HLA-associated polymorphisms in patient HIV-1 sequences were determined based on a published list. Statistical Analysis. A comparison of host genetic, immunologic, and viral sequence characteristics of those with and without initial viral suppression was performed using the 2-sample Wilcoxon rank sum test. Fisher’s exact tests were used to compare dichotomous outcomes between initial viral suppressors and the non-suppressors. All of the p-values are exact 2-sided p-values. No adjustments were performed for multiple comparisons. Note that the comparisons presented here were not originally planned in the protocol. Metho
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