Effect of combination antiretroviral therapy on T-cell immunity in acute human immunodeficiency virus type 1 infection.
T-cell responses were evaluated prospectively in 41 patients with acute human immunodeficiency virus type 1 (HIV-1) infection (30 untreated and 11 receiving zidovudine, lamivudine, and indinavir) and in 38 uninfected adults. By 6-12 months, treated patients had significantly greater median Candida and tetanus lymphoproliferative responses (stimulation index [SI], 76 and 55, respectively) than did untreated patients (SI, 7 and 6, P=.02 and.001, respectively), and the responses of treated patients surpassed those of uninfected adults (SI, 19 and 32, P= .002 and .101, respectively). Unlike the patients in the untreated group, the patients in the treated group mounted a 6-fold increased HIV-1 p24 response (SI increase, 1.0 to 5.7, P= .01) within 3 months. HIV-1-specific cytotoxicity remained detectable in most treated patients. Thus, combination therapy administered within 3-4 months of infection was associated with improved T-cell memory responses that were distinct from those of untreated patients. The amplified HIV-1-specific T-cell responses may help maintain cytotoxic activities.
Malhotra
U
U
Department of Medicine, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Berrey
M M
MM
Huang
Y
Y
Markee
J
J
Brown
D J
DJ
Ap
S
S
Musey
L
L
Schacker
T
T
Corey
L
L
McElrath
M J
MJ
D000208:Acute Disease; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000276:immunology; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D003602:Cytotoxicity, Immunologic; D004359:Drug Therapy, Combination; D005260:Female; D015488:HIV Antigens / Q000276:immunology; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D015497:HIV-1 / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D013745:Tetanus Toxoid / Q000276:immunology; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D016207:Cytokines; D015488:HIV Antigens; D013745:Tetanus Toxoid; D019259:Lamivudine; D015215:Zidovudine; D019469:Indinavir