title: Effect of antiretroviral therapy on HIV-1 genetic evolution during acute infection.
abstract: The rapid evolution of HIV-1 is a major obstacle to viral eradication. Early antiretroviral therapy (ART) during primary HIV-1 infection could limit viral diversity. Eighteen patients recently infected with HIV-1 were selected. Nine initiated ART soon after enrolment and nine remained untreated. Replication-competent (RC) viruses were quantified at baseline and after one year of follow-up. Viral diversity in the C2V5 envelope region was evaluated from plasma, peripheral blood mononuclear cells (PBMCs), and cell culture at both time points. The amount of RC virus in the treated group declined (median -5.42 infectious units per million [IUPM]) while it remained stable or increased in the untreated group (median +0.87 IUPM). At one year post infection, we observed a significant increase in diversity for the C2V5 (+0.150%) region, specifically in the hypervariable loops V4 (+0.73%) and V5 (+0.77%), in the untreated group. More importantly, viral diversity did not significantly increase in treated individuals during the first year post infection. Genetic diversity during primary infection remains low through the first year of infection. Early treatment could contribute to a decrease in RC viruses from PBMCs and to limitation of viral diversification in the viral reservoir. These findings may have relevance for the rational design of specific immunotherapeutic strategies.
authors.affiliation: Centre de Recherche du CHUM (CRCHUM).
authors.forename: A
authors.initials: A
authors.lastname: Chamberland
authors.forename: M
authors.initials: M
authors.lastname: Sylla
authors.forename: M R
authors.initials: MR
authors.lastname: Boulassel
authors.forename: J-G
authors.initials: JG
authors.lastname: Baril
authors.forename: P
authors.initials: P
authors.lastname: Côté
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: B
authors.initials: B
authors.lastname: Trottier
authors.forename: D
authors.initials: D
authors.lastname: Rouleau
authors.forename: J-P
authors.initials: JP
authors.lastname: Routy
authors.forename: C
authors.initials: C
authors.lastname: Tremblay
mesh_terms: D000208:Acute Disease; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D019143:Evolution, Molecular; D005260:Female; D014644:Genetic Variation; D015699:HIV Envelope Protein gp120 / Q000737:chemistry / Q000235:genetics; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000235:genetics; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D044966:Anti-Retroviral Agents; D015699:HIV Envelope Protein gp120; D010446:Peptide Fragments