Potent antiretroviral therapy of primary human immunodeficiency virus type 1 (HIV-1) infection: partial normalization of T lymphocyte subsets and limited reduction of HIV-1 DNA despite clearance of plasma viremia

J Infect Dis. 1999 Aug;180(2):320-9. doi: 10.1086/314880.

Abstract

Antiretroviral therapy commenced during primary human immunodeficiency virus 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 protease inhibitor) in 16 patients with symptomatic PHI. In the 13 patients who completed 1 year of treatment, plasma HIV RNA was <50 copies/mL and median CD4 cell counts were comparable to HIV-uninfected controls, with naive (CD45RA+CD62L+), primed (CD45RO+), and T cell receptor Vbeta subsets all within normal ranges. However, HIV-1 DNA levels in treated and untreated PHI patients were similar. Furthermore, CD8 cell counts remained elevated, including activated (CD38+HLA-DR+), replicating (Ki-67+), and cytotoxic (perforin+CD28-) lymphocytes. In conclusion, early antiretroviral therapy resulted in clearance of viremia and prevented loss of crucial CD4 subsets. The persistence of HIV-1 DNA together with increased CD8 T lymphocyte turnover and activation indicate continued expression of viral antigens.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • CD4-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / immunology
  • Cohort Studies
  • DNA, Viral / blood
  • Drug Therapy, Combination
  • HIV Antibodies / blood
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Infections / virology
  • HIV-1 / physiology*
  • Humans
  • Indinavir / therapeutic use
  • Lamivudine / therapeutic use
  • Leukocytes, Mononuclear / virology
  • Lymphocyte Activation
  • Male
  • Prospective Studies
  • RNA, Viral / blood
  • T-Lymphocyte Subsets / immunology*
  • Viremia / drug therapy
  • Viremia / virology
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • DNA, Viral
  • HIV Antibodies
  • RNA, Viral
  • Lamivudine
  • Zidovudine
  • Indinavir