Early production of HIV-1 neutralising antibodies in patients following highly active antiretroviral treatment (HAART) during primary HIV infection

We investigate the effects of highly active antiretroviral therapy (HAART) on humoral immune responses during a 24-month follow up of 15 HIV patients with acute primary HIV infection. The patients were divided into three grou ps on the basis of the therapeutic protocol they were following at the time of entry: a) five naive patients (untreated or treated with only ZDV or AZ T); b) five patients following a triple combination of ZDV+ lamivudine (3TC )+ saquinovir (SQV); and c) five patients on a four-drug combination of ZDV +3TC+SQV+ ritonavir (RTV). The results show that the early introduction of HAART greatly reduces plasm a viremia levels and restores the number of CD4 cells. A significant correl ation was found between anti HIV neutralising activity and the four-drug, b ut not the three-drug combination. The reduction in infectivity was directe d against viruses of different clades and associated with immunoglobulin fr actions. Moreover, the neutralising antibodies in the HAART-treated patient s appeared after two weeks of treatment and remained stable throughout the 24 months of follow up. The early appearance of neutralising antibodies represent an important comp onent of immune responses during primary HIV infection, may contribute towa rds immune reconstitution in patients on HAART, and give further informatio n that may be useful in developing new strategies designed to eradicate the disease.