Effect of combination antiretroviral therapy on T-cell immunity in acute human immunodeficiency virus type 1 infection

T-cell responses were evaluated prospectively in 41 patients with acute hum an immunodeficiency virus type 1 (HIV-1) infection (30 untreated and ii rec eiving zidovudine, lamivudine, and indinavir) and in 38 uninfected adults. By 6-12 months, treated patients had significantly greater median Candida a nd tetanus lymphoproliferative responses (stimulation index [SI], 76 and 55 , respectively) than did untreated patients (SI, 7 and 6, P = .02 and .001, respectively), and the responses of treated patients surpassed those of un infected adults (SI, 19 and 32, P = .002 and .101, respectively). Unlike th e patients in the untreated group, the patients in the treated group mounte d a 6-fold increased HIV-1 p24 response (SI increase, 1.0 to 5,7, P = .01) within 3 months. HIV-1-specific cytotoxicity remained detectable in most tr eated patients. Thus, combination therapy administered within 3-4 months of infection was associated with improved T-cell memory responses that were d istinct from those of untreated patients. The amplified HIV-1-specific T-ce ll responses may help maintain cytotoxic activities.