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Background  The impact of HIV-1 subtype (CRF01_AE and non-CRF01_AE) on HIV-1 DNA levels in HIV-1 chronically infected patients with suppressive antiretroviral therapy (ART) remains poorly understood. To evaluate the correlation of HIV-1 subtype with DNA level, and identify baseline predictors of HIV-1 DNA decay.    Methods  ART-naïve HIV-1-infected patients from two large multi-center studies in China were classified into CRF01_AE and non-CRF01_AE subtype groups. Peripheral blood samples were collected at baseline and week 12, 24, 48 and 96 after ART initiation and total HIV-1 DNA levels were quantified by real-time PCR. HIV-1 DNA levels at week 96 were categorized into high, moderate, and low levels, reflecting HIV-1 DNA ≥ 3, 2–3, ≤ 2 log 10  copies/10 6  PBMCs, respectively, and the corresponding proportion of CRF01_AE and non-CRF01_AE subtype were compared. The baseline predictors of low HIV-1 total DNA levels (≤ 2 log 10  copies/10 6  PBMCs) at week 96 were evaluated using a logistic regression model.    Results  Compared to the non-CRF01_AE subtypes ( n  = 185), patients with CRF01_AE subtype ( n  = 188) harboured a higher level of HIV-1 DNA (median: 3.19 vs. 2.95 log 10  copies/10 6  PBMCs,  P  < 0.001) prior to treatment. After 96 weeks of ART, HIV-1 DNA levels remained higher in the CRF01_AE subtype group (median: 2.63 vs. 2.39 log 10  copies/10 6  PBMCs,  P  = 0.002). There was no significant difference in the proportion of patients achieving high (22.3% vs. 14.6%,  P  = 0.054), moderate (59.6% vs. 60.5%,  P  = 0.849) and low levels (18.1% vs 24.9%,  P  = 0.111) between CRF01_AE and non-CRF01_AE groups. In the multivariable analysis, baseline HIV-1 DNA level and CD4 +  T cell count but not the subtype were independent risk factors for achieving HIV-1 DNA level ≤ 2 log 10  copies/10 6  PBMCs.    Conclusion  HIV-1 CRF01_AE subtype is neither correlated with HIV-1 DNA reservoir decline nor a prognostic factor for achieving lower HIV-1 DNA levels (≤ 2 log 10  copies/10 6  PBMCs) after ART. However, higher HIV-1 DNA level in HIV-1 CRF01_AE patients should be aroused much attention and strengthen surveillance during ART.

HIV-1 CRF01_AE subtype and HIV-1 DNA level among patients with chronic HIV-1 infection: a correlation study