Antiviral Activity of Peg-IFN-Alpha-2A in Chronic HIV-1 Infection

Inclusion Criteria: * Male or female, age ≥ 18 but \<65 years * Able and willing to provide informed consent. * HIV-1 infection documented by any licensed enzyme-linked immunosorbent assay (ELISA) test kit and confirmed by Western Blot at any time prior to or at study entry. HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA is acceptable as an alternative confirmatory test * HIV RNA \< 75 copies/ml on a regimen of a) 2 Nucleoside Reverse Transcriptase Inhibitors (NRTIs) and 1 non-nucleoside RTI (NNRTI) OR b) 2 NRTIs and Protease Inhibitor (PI) for at least 24 weeks OR c) 3 NRTIs * HIV RNA \< 75 copies/ml at screening * \> 6 months ≥ 400 CD4+ T cells/mm3 (CD4 nadir ≥ 200 cells) * Female subjects with childbearing potential: negative pregnancy test (Beta human horionic gonadotropin (HCG)). Must agree to use appropriate contraceptive methods (barrier devices such as diaphragms or condoms + spermicidal or intrauterine device (IUD) or oral contraceptives) while on study. * Karnofsky performance scale score of 80% or better * Willing to adhere to the treatment and schedule approved by the study investigators in conjunction with the patient's primary provider. * Willing to abstain from immunomodulatory drugs during the study period, with the exception of the study drug (Pegasys®). * Patient Health Questionnaire (PHQ)-2 score \< 2, OR PHQ-9 score\< 10, OR PHQ-9 score 10-14 AND medical provider's favorable opinion. In either case, score for PHQ-9 question # 9 (suicidal ideation) must be 0. * Thyroid stimulating hormone (TSH) within normal range, unless accompanied by thyroid profile consistent with normal thyroid function * A negative cardiac stress test if \>45yrs men/\>55yrs women years of age or if below these years of age but with two added risk factors for coronary artery disease \[smoking, hypertension (BP \>140/90 or on antihypertensive medications), low Hight density lipoprotein (HDL)-associated cholesterol (\<40 mg/dL), family history of premature Coronary heart disease (CHD) (\<55 yrs males/\<65 females)\] or a Framingham score \> 15% (men) or 10% (women)) Exclusion Criteria: * Currently pregnant or breast feeding. * CD4 cell count \< 400 or recorded CD4 nadir \< 200 cells/mm3 * History of immunomodulatory therapy for over 2 weeks during the 6 months prior to enrollment, including, but not limited to: IFN-Alpha or Beta (recombinant or pegylated), systemic corticosteroids; systemic cancer chemotherapy/irradiation; cyclosporin; tacrolimus (FK-506); OKT-3; any Interleukin, including IL-2; cyclophosphamide; methotrexate; IVIG (gamma globulin); G/M-CSF; hydroxyurea; thalidomide; pentoxifylline; thymopentin; thymosin; dithiocarbonate; polyribonucleoside. * Significant co-existing medical conditions including: Anemia (Hgb \<9.1 men, \<8.9 women), Neutropenia (ANC \< 1000), Thrombocytopenia (platelet count \<50K), Liver disease (AST/ALT \> 5x, Total Bilirubin \> 1.5x upper limits of normal, or Total Bilirubin \>3x upper limit of the norm (ULN) if receiving indinavir), Renal disease (creatinine \> 2x upper normal limits), or other conditions, such as active drug/alcohol abuse or dependence which would interfere with study compliance. * Any history of heart attacks, myocardial infarction or coronary arterial disease (MI/CAD). . * Prior history of major depression or other severe psychiatric disorder/condition requiring treatment and/or hospitalization * PHQ-9 score \>14, OR PHQ-9 score \> 10 - 14 and lack of medical provider's favorable opinion, or score for PHQ-9 answer # 9 (suicidal ideation) \> 0. * Evidence of chronic active Hepatitis B infection (Surface Antigen HBsAg) or Hepatitis C plymerase chain reaction (PCR) positivity at screening (cleared of HCV at entry \>6 months). * Past evidence of medical conditions associated with chronic liver disease including genetic hemochromatosis, autoimmune hepatitis, alcoholic liver disease, toxin exposures etc. * History of neutropenia or other hematological abnormalities * Type I diabetes mellitus, or type II diabetes mellitus that is not controlled with oral agents and/or insulin. * Ongoing treatment with Isoniazide, Pyrazinamide, Rifabutin, Rifampicin, Diadenosine Ganciclovir, Valganciclovir, Oxymetholone, Thalidomide or Theophylline. * History of autoimmune processes including Crohn's disease, ulcerative colitis, severe psoriasis, rheumatoid arthritis, myositis, hepatitis etc. * History of major organ transplantation with an existing functional graft. * Active coronary artery disease within 24 weeks prior to study * Hemoglobinopathies such as sickle cell anemia or Thalassemia major. * Hypersensitivity to Pegasys®or any of its components.