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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; 180(2):320-9JI

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.

Authors+Show Affiliations

Centre for Immunology, St. Vincent's Hospital, UNSW, Darlinghurst, Australia 2010 Australia. J.Zaunders@cfi.unsw.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

10395845

Citation

Zaunders, J J., et al. "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." The Journal of Infectious Diseases, vol. 180, no. 2, 1999, pp. 320-9.
Zaunders JJ, Cunningham PH, Kelleher AD, et al. 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;180(2):320-9.
Zaunders, J. J., Cunningham, P. H., Kelleher, A. D., Kaufmann, G. R., Jaramillo, A. B., Wright, R., ... Cooper, D. A. (1999). 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. The Journal of Infectious Diseases, 180(2), pp. 320-9.
Zaunders JJ, et al. 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;180(2):320-9. PubMed PMID: 10395845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Zaunders,J J, AU - Cunningham,P H, AU - Kelleher,A D, AU - Kaufmann,G R, AU - Jaramillo,A B, AU - Wright,R, AU - Smith,D, AU - Grey,P, AU - Vizzard,J, AU - Carr,A, AU - Cooper,D A, PY - 1999/7/9/pubmed PY - 2000/3/21/medline PY - 1999/7/9/entrez SP - 320 EP - 9 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 180 IS - 2 N2 - 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. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/10395845/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_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/314880 DB - PRIME DP - Unbound Medicine ER -