EARLY ESTABLISHMENT OF A POOL OF LATENTLY INFECTED, RESTING CD4(-CELLS DURING PRIMARY HIV-1 INFECTION() T)

The presence of latently infected, resting CD4(+) T cells carrying rep lication-competent HIV-I has been demonstrated in chronically infected individuals who are antiretroviral therapy naive as well as in those who are receiving highly active antiretroviral therapy (HAART), It is not clear, however, whether the establishment of a pool of latently in fected CD4(+) T cells can be blocked by early initiation of HAART afte r primary infection. The present st;dy demonstrates that initiation of HAART in infected individuals as early as 10 days after the onset of symptoms of primary HIV-1 infection did not prevent generation of late ntly infected, resting CD4(+) T cells carrying integrated HIV-1 DNA as well as infectious HIV-I despite the successful control of plasma vir emia shortly after institution of HAART. Furthermore, there was no cor relation between either the duration of HAART at the time of study (ra nge: 0.2-17 months) or the time of initiation of HAART after the onset of symptoms of primary HIV-1 infection (range: 0.3-4 months) and the frequencies of resting CD4(+) T cells carrying either integrated HIV-1 DNA or infectious virus. These results underscore the rapidity with w hich latent reservoirs are established in primary HIV-1 infection and indicate that it is unlikely that early treatment during primary infec tion can prevent establishment of a pool of latently infected, resting CD4(+) T cells as long as treatment is initiated after plasma viremia becomes evident.