title: Treatment of human immunodeficiency virus infection with hydroxyurea, didanosine, and a protease inhibitor before seroconversion is associated with normalized immune parameters and limited viral reservoir.
abstract: Current treatments for human immunodeficiency virus (HIV) require uninterrupted drug administration because they are unable to reconstitute the immune response and do not affect the viral reservoir. Ten patients were treated during acute HIV infection before complete Western blot (WB) seroconversion with the combination of hydroxyurea, didanosine, and indinavir. This treatment was associated with the normalization of some immune parameters and functions. No loss of naive CD4 T lymphocytes was observed, and recovery of up to 35% of naive CD8 T lymphocytes occurred in several weeks. A vigorous HIV-specific T helper response (stimulation index >8) was observed in 7 of 8 patients treated before complete WB seroconversion but in only 1 of 5 controls treated after seroconversion. In addition, a limited latent viral reservoir (<0.02-0.5 infectious units/106 cells) was documented in quiescent peripheral blood lymphocytes after treatment initiated before complete WB seroconversion.
authors.affiliation: RIGHT, Medical-Dental Bldg. SW307, Washington, DC 20007, USA. RIGHT@gunet.georgetown.edu
authors.forename: F
authors.initials: F
authors.lastname: Lori
authors.forename: H
authors.initials: H
authors.lastname: Jessen
authors.forename: J
authors.initials: J
authors.lastname: Lieberman
authors.forename: D
authors.initials: D
authors.lastname: Finzi
authors.forename: E
authors.initials: E
authors.lastname: Rosenberg
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.forename: B
authors.initials: B
authors.lastname: Walker
authors.forename: R F
authors.initials: RF
authors.lastname: Siliciano
authors.forename: J
authors.initials: J
authors.lastname: Lisziewicz
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015153:Blotting, Western; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016049:Didanosine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005434:Flow Cytometry; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D019469:Indinavir / Q000627:therapeutic use*; D008213:Lymphocyte Activation; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D015483:HIV Antibodies; D017320:HIV Protease Inhibitors; D019469:Indinavir; D016049:Didanosine; D006918:Hydroxyurea