Antiretroviral therapy initiated during acute HIV infection fails to prevent persistent T-cell activation

Abstract

Initiation of antiretroviral therapy during acute HIV-1 infection may prevent persistent immune activation. We analyzed longitudinal CD38+HLA-DR+ CD8+ T-cell percentages in 31 acutely infected individuals who started early (median 43 days since infection) and successful antiretroviral therapy, and maintained viral suppression through 96 weeks. Pretherapy a median of 72.6% CD8+ T cells were CD38+HLA-DR+, and although this decreased to 15.6% by 96 weeks, it remained substantially higher than seronegative controls (median 8.9%, P = 0.008). Shorter time to suppression predicted lower activation at 96 weeks. These results support the hypothesis that very early events in HIV-1 pathogenesis may result in prolonged immune dysfunction.

Figures

Figure 1. CD8+ cell activation in AHI patients during 96 weeks of ART

Dynamics of CD8+ cell activation among 31 ART-treated acutely HIV infected individuals and comparison of 96 week activation levels to 30 seronegative controls.