Early and persistent human immunodeficiency virus type 1 (HIV-1)-specific T helper dysfunction in blood and lymph nodes following acute HIV-1 infection.
Without potent antiretroviral therapy, most human immunodeficiency virus type 1 (HIV-1)-infected persons experience a progressive decline in CD4+ T cells and impairment in T helper function. It is unclear how soon after infection T cell dysfunction occurs. T helper responses were examined in blood and lymphoid tissue of 39 untreated patients with acute HIV-1 infection. Within the first 3 months, lymphoproliferative responses to mitogen, recall antigens, and HIV-1 antigens were impaired. After 6-9 months, responses to phytohemagglutinin and recall antigens improved. However, HIV-1-specific lymphoproliferation remained largely undetectable throughout 2 years of infection, and results were similar upon evaluation of lymphoid cells. Rare patients with HIV-1-specific responses had significantly lower plasma HIV-1 RNA levels than did nonresponders. These results indicate that T helper dysfunction occurs early after HIV-1 acquisition and that untreated individuals rarely recover HIV-specific helper responses; these findings lend support for early therapeutic intervention to prevent the destruction and further impairment of the T helper cells.
Musey
L K
LK
Department of Medicine, University of Washington School of Medicine, Seattle, WA 98109, USA.
Krieger
J N
JN
Hughes
J P
JP
Schacker
T W
TW
Corey
L
L
McElrath
M J
MJ
D000328:Adult; D002175:Candida / Q000276:immunology; D005260:Female; D016655:HIV Core Protein p24 / Q000276:immunology; D015699:HIV Envelope Protein gp120 / Q000276:immunology; D015658:HIV Infections / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000276:immunology; D008198:Lymph Nodes / Q000166:cytology / Q000276:immunology*; D008213:Lymphocyte Activation; D008297:Male; D010835:Phytohemagglutinins / Q000276:immunology; D011994:Recombinant Proteins / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D013742:Tetanus / Q000276:immunology
D016655:HIV Core Protein p24; D015699:HIV Envelope Protein gp120; D010835:Phytohemagglutinins; D011994:Recombinant Proteins