Effective highly active antiretroviral therapy in patients with primary HIV-1 infection prevents the evolution of the avidity of HIV-1-specific antibodies.
OBJECTIVE
To evaluate if the administration of highly active antiretroviral therapy (HAART) during primary HIV infection (PHI) may affect the antibody avidity evolution.


METHODS
In 13 subjects with symptomatic PHI, of whom 8 initiated HAART at diagnosis, the Avidity Index (AI) and Western blot evolution patterns were analyzed on serial serum/plasma samples for 1 year. In 4 patients, who subsequently interrupted HAART, additional specimens were analyzed.


RESULTS
At diagnosis, the range of HIV viremia was 0.003 to 38 x 10(6) copies/mL. In untreated patients, viremia reached the set point in 4 to 6 months, whereas in treated patients, early suppression of viremia was observed, remaining undetectable during therapy. At diagnosis, the median AI was low in untreated (0.42, range: 0.33 to 0.43) and treated (0.44, range: 0.40 to 0.72) patients. At 3, 6, and 12 months, the AI progressively increased in untreated patients, whereas it remained <0.80 in all treated patients. In the 4 patients interrupting HAART, the AI increased after therapy interruption to greater than 0.80 in < or = 6 months. The Western blot pattern transiently/partially reversed during HAART in 2 patients.


CONCLUSIONS
Antibody avidity maturation takes place only in the presence of ongoing viral replication. These results may have relevant implications in understanding the complex mechanism of maturation of the immune response to HIV.
Selleri
Marina
M
Laboratorio di Virologia, Istituto Nazionale per le Malattie Infettive L. Spallanzani, Rome, Italy.
Orchi
Nicoletta
N
Zaniratti
Maria Stefania
MS
Bellagamba
Rita
R
Corpolongo
Angela
A
Angeletti
Claudio
C
Ippolito
Giuseppe
G
Capobianchi
Maria Rosaria
MR
Girardi
Enrico
E
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000915:Antibody Affinity; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015483:HIV Antibodies / Q000097:blood / Q000276:immunology*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D044966:Anti-Retroviral Agents; D015483:HIV Antibodies