COURSE OF SPECIFIC T-LYMPHOCYTE CYTOTOXICITY, PLASMA AND CELLULAR VIRAL LOADS, AND NEUTRALIZING ANTIBODY-TITERS IN 17 RECENTLY SEROCONVERTED HIV TYPE 1-INFECTED PATIENTS

Relationships were sought between specific anti-HIV cytotoxic T lympho cyte (CTL) responses (against structural and regulatory proteins of th e HIV-1 LAI isolate) and plasma and cellular viral loads (VLs) in 17 r ecently HIV-1-infected patients including 3 displaying asymptomatic pr imary infection (PI) followed up for 12 months, Plasma VL was correlat ed directly with CD8 counts and inversely with CD4 counts, Cytotoxic r eactions were observed in all patients and directed mainly against str uctural proteins, The earliest CTL responses were against Gag and Env proteins detected in 87 and 75% of the subjects, respectively, within the first month following PI, Anti-Env and Gag cytotoxic responses wer e inversely correlated with the plasma VL, Reactions against the pol g ene products were thought to be either less involved in or less effici ent for the initial decrease of viremia, Responses against regulatory gene products were weak and variable, apart from Nef, which was recogn ized by half of the subjects, Neutralizing antibodies were not detecte d before month 3, and were found only in six patients at subsequent ti mes, Two of three patients with asymptomatic PI had a low viral burden and either a delayed response or one limited to a few protein CTL res ponses, suggesting that the magnitude of the CTL response depends on t he initial plasma VL, The third patient displayed viral and CTL parame ters identical to those of the patients with symptomatic PI. However, two subjects with symptomatic PI exhibited similarly low plasma VL and moderate CTL responses, Overall, the results suggest that the CTL res ponse may not be the sole factor controlling viremia.