title: Effective highly active antiretroviral therapy in patients with primary HIV-1 infection prevents the evolution of the avidity of HIV-1-specific antibodies.
abstract: 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.
authors.affiliation: Laboratorio di Virologia, Istituto Nazionale per le Malattie Infettive L. Spallanzani, Rome, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Selleri
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Orchi
authors.forename: Maria Stefania
authors.initials: MS
authors.lastname: Zaniratti
authors.forename: Rita
authors.initials: R
authors.lastname: Bellagamba
authors.forename: Angela
authors.initials: A
authors.lastname: Corpolongo
authors.forename: Claudio
authors.initials: C
authors.lastname: Angeletti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Capobianchi
authors.forename: Enrico
authors.initials: E
authors.lastname: Girardi
mesh_terms: 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
chemical_list: D044966:Anti-Retroviral Agents; D015483:HIV Antibodies