EVOLUTION OF CYTOTOXIC T-LYMPHOCYTE RESPONSES TO HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 IN PATIENTS WITH SYMPTOMATIC PRIMARY INFECTION RECEIVING ANTIRETROVIRAL TRIPLE THERAPY

The impact of highly active antiretroviral treatment (HAART) on anti-h uman immunodeficiency virus (HIV) cytotoxic T lymphocytes (CTL) was st udied in 17 patients with recent symptomatic HIV-1 primary infection r eceiving triple combination therapy. Anti-HIV CTL were initially detec ted in 15 patients. In 6, CTL disappeared rapidly and persistently aft er initiation of therapy. Most of them had a rapid and sustained decre ase in plasma HIV RNA to undetectable levels. Conversely, in 6 other p atients, CTL remained detectable, which was associated with a less eff icient control of viral replication. In 3 others, CTL disappeared only transiently, without clear correlation with the virologic profile. Al together, despite individual variations, there was a positive correlat ion between viral replication and anti-HIV-l cytotoxicity in most subj ects, suggesting that the persistence of viral antigens is the main de terminant for the maintenance of CTL activity. This raises the questio n of the potential benefit of anti-HIV CTL induction by immunotherapy in acute seroconverters treated by HAART.