Immunological and virological responses in HIV-1-infected adults at early stage of established infection treated with highly active antiretroviral therapy.
OBJECTIVE
To evaluate the immunological and virological responses to highly active antiretroviral therapy (HAART) in blood and lymphoid compartments of HIV-1-infected patients at an early stage of infection.


METHODS
An open-label, observational, non-randomized, prospective trial of outpatients attending the Centre of Clinical Investigation in Infectious Diseases, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland.


METHODS
Forty-one antiretroviral-naive HIV-1-infected adults with 400 CD4 T cells/microl or greater and 5000 plasma HIV-1-RNA copies/ml or greater were enrolled, and 32 finished the study. Forty-nine HIV-negative individuals were included as controls. All subjects gave written informed consent.


METHODS
All patients received abacavir 300 mg by mouth every 12 h and amprenavir 1200 mg by mouth every 12 h for 72 weeks.


METHODS
The extent of immune reconstitution in blood and lymph nodes after 72 weeks of HAART was evaluated, and compared with immunological measures of 49 HIV-negative subjects.


RESULTS
Virus replication was effectively suppressed (-3.5 log10 at week 72). Substantial increments of CD4 T cell count in blood and percentage in lymph nodes were observed over time, and these measures were comparable to HIV-negative subjects by week 24 in blood and by week 48 in lymph nodes. The increase was equally distributed between naive and memory CD4 T cells. Recovery of HIV-specific CD4 responses occurred in 40% of patients.


CONCLUSIONS
The initiation of HAART at an early stage of established HIV infection induces systemic quantitative normalization of CD4 T cells, a partial recovery of HIV-specific CD4 cell responses, and effective and durable suppression of virus replication.
Bart
P A
PA
Department of Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland.
Rizzardi
G P
GP
Tambussi
G
G
Chave
J P
JP
Chapuis
A G
AG
Graziosi
C
C
Corpataux
J M
JM
Halkic
N
N
Meuwly
J Y
JY
Munoz
M
M
Meylan
P
P
Spreen
W
W
McDade
H
H
Yerly
S
S
Perrin
L
L
Lazzarin
A
A
Pantaleo
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D002219:Carbamates; D015224:Dideoxynucleosides / Q000627:therapeutic use*; D005260:Female; D005663:Furans; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use*; D019562:Viral Load; D000099227:Abacavir
D002219:Carbamates; D015224:Dideoxynucleosides; D005663:Furans; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D013449:Sulfonamides; D000099227:Abacavir; C095108:amprenavir