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The HEATHER cohort: ‘HIV Eradication through Early Antiretroviral Therapy’

Study completed (2015-2021)

There is currently no cure for HIV infection. Antiretroviral therapy (or 'ART') can prevent disease progression and has revolutionised the management of HIV infection. Although ART is not a cure, there are a growing number of cases of individuals who have started ART very early in HIV infection and then have stopped treatment, but with no evidence of the virus coming back. This phenomenon of post-treatment control (or 'PTC') has attracted much interest and may help provide key insights into how to cure HIV.
The HEATHER study was a cohort study which is part of the CHERUB collaboration (see below in A6-2) and was designed to explore the impact of ART on the HIV 'reservoir' - the pool of latent (or 'sleeping') HIV that persists on ART and the reason current therapies need to be taken life-long. To achieve the longer term goal of understanding PTC, we first needed to identify a large cohort of recently infected HIV+ve individuals who started ART shortly after infection. Once identified, we measured a number of biomarkers such as T cell immunity and HIV DNA levels, to monitor the impact of ART on the reservoir. These patients are rare, and so we needed to recruit at a number of centres across the UK.
The aim of this study was to allow us to set up the HEATHER cohort and to start taking blood samples to allow a detailed prospective analysis of the impact of ART on the reservoir. There was no intervention, beyond taking the extra blood samples. All patients were managed according to current UK guidelines. The research was funded by the Medical Research Council and the British HIV Association and recruited in the UK at three NHS Trusts (Chelsea and Westminster, Guy's and St Thomas' and Imperial NHS Trusts).

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