TEMPORAL ASSOCIATION OF CELLULAR IMMUNE-RESPONSES WITH THE INITIAL CONTROL OF VIREMIA IN PRIMARY HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 SYNDROME

Virologic and immunologic studies were performed on five patients pres enting with primary human immunodeficiency virus type 1 (HIV-1) infect ion. CD8(+) cytotoxic T lymphocyte (CTL) precursors specific for cells expressing antigens of HIV-1 Gag, Pol, and Env were detected at or wi thin 3 weeks of presentation in four of the five patients and were det ected in all five patients by 3 to 6 months after presentation. The on e patient with an absent initial CTL response had prolonged symptoms, persistent viremia, and low CD4(+) T cell count. Neutralizing antibody activity was absent at the time of presentation in all five patients. These findings suggest that cellular immunity is involved in the init ial control of virus replication in primary HIV-1 infection and indica te a role for CTL in protective immunity to HIV-1 in vivo.