Antiretroviral therapy (ART) inhibits HIV replication but does not eradicate the latent reservoir. The previous research suggests that earlier ART initiation provides benefit on limiting reservoir size, but timing and extent of this effect remain unclear. Analytic treatment interruption (ATI) may be used to demonstrate HIV remission, but whether early ART also improves likelihood or duration of even temporary virologic remission is unclear. This review seeks to answer both questions. We performed a systematic review and analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and included 21 interventional or observational studies with sufficient HIV reservoir outcomes. We also aggregated reservoir outcomes and transformed data into approximate measurements of total HIV DNA per million peripheral blood mononuclear cells and analyzed the correlation between timing of ART initiation and reservoir size. People living with HIV who initiate ART in primary infection maintain smaller reservoirs on suppressive ART than those who initiate treatment during chronic infection. The reduction of reservoir is most pronounced when ART is started within 2 weeks of HIV acquisition. Across studies, we found a moderately strong association between longer time to ART initiation and reservoir size, which was strongest when measured after 1 year on ART (Pearson's r = 0.69, p = 0.0003). After ATI, larger pre-ATI reservoir size predicts shorter time to viral rebound. Early ART may also facilitate long-term control of viremia. Although achieving sustained HIV remission will require further interventions, initiating ART very early in infection could limit the extent of the reservoir and also lead to post-ATI control in rare cases.

中文翻译：

---

在原发性 HIV 感染期间启动抗逆转录病毒治疗：对潜伏性 HIV 病毒库的影响，包括对分析性治疗中断的影响。

抗逆转录病毒疗法 (ART) 会抑制 HIV 复制，但不能根除潜在的病毒库。先前的研究表明，较早开始 ART 有助于限制储层大小，但这种影响的时间和程度仍不清楚。分析性治疗中断 (ATI) 可用于证明 HIV 缓解，但早期 ART 是否也能提高暂时病毒学缓解的可能性或持续时间尚不清楚。本综述旨在回答这两个问题。我们按照系统评价和 Meta 分析的首选报告项目指南进行了系统评价和分析，并纳入了 21 项具有足够 HIV 储存库结果的干预性或观察性研究。我们还汇总了储库结果并将数据转换为每百万外周血单核细胞总 HIV DNA 的近似测量值，并分析了 ART 启动时间与储库大小之间的相关性。与在慢性感染期间开始治疗的人相比，在原发感染中开始 ART 的 HIV 感染者在抑制性 ART 中保持较小的储存库。在 HIV 感染后 2 周内开始 ART 时，病毒库的减少最为明显。在所有研究中，我们发现 ART 启动的较长时间与储层大小之间存在中等强的关联，在 ART 1 年后测量时这种关联最强（Pearson's r = 0.69，p = 0.0003）。在 ATI 之后，较大的 pre-ATI 水库大小预测病毒反弹的时间较短。早期 ART 还可以促进病毒血症的长期控制。