Potent antiretroviral therapy of primary human immunodeficiency virus type1 (HIV-1) infection: Partial normalization of T lymphocyte subsets and limited reduction of HIV-1 DNA despite clearance of plasma viremia
Jj. Zaunders et al., Potent antiretroviral therapy of primary human immunodeficiency virus type1 (HIV-1) infection: Partial normalization of T lymphocyte subsets and limited reduction of HIV-1 DNA despite clearance of plasma viremia, J INFEC DIS, 180(2), 1999, pp. 320-329
Antiretroviral therapy commenced during primary human immunodeficiency viru
s type 1 (HIV-1) infection (PHI) may limit the extent of viral replication
and prevent early loss of HIV-specific CD4 lymphocyte function. We studied
the effect of current standard therapy (2 nucleoside analogues and a protea
se inhibitor) in 16 patients with symptomatic PHI, In the 13 patients who c
ompleted 1 year of treatment, plasma HIV RNA was <50 copies/mL and median C
D4 cell counts were comparable to HIV-uninfected controls, with naive (CD45
RA+CD62L+), primed (CD45RO+), and T cell receptor V beta subsets all within
normal ranges. However, HIV-1 DNA levels in treated and untreated PHI pati
ents were similar. Furthermore, CD8 cell counts remained elevated, includin
g activated (CD38+HLA-DR+), replicating (Ki-67+), and cytotoxic (perforin+C
D28-) lymphocytes, In conclusion, early antiretroviral therapy resulted in
clearance of viremia and prevented loss of crucial CD4 subsets. The persist
ence of HIV-1 DNA together with increased CD8 T lymphocyte turnover and act
ivation indicate continued expression of viral antigens.