title: T cell activation but not polyfunctionality after primary HIV infection predicts control of viral load and length of the time without therapy.
abstract: OBJECTIVE
  Immune changes occurring after primary HIV infection (PHI) have a pivotal relevance. Our objective was to characterize the polyfunctionality of immune response triggered by PHI, and to characterize immune activation and regulatory T cells, correlating such features to disease progression.
  
  
  METHODS
  We followed 11 patients experiencing PHI for 4 years. By polychromatic flow cytometry, we studied every month, for the first 6 months, T lymphocyte polyfunctionality after cell stimulation with peptides derived from HIV-1 gag and nef. Tregs were identified by flow cytometry, and T cell activation studied by CD38 and HLA-DR expression.
  
  
  RESULTS
  An increase of anti-gag and anti-nef CD8+ specific T cells was observed 3 months after PHI; however, truly polyfunctional T cells, also able to produce IL-2, were never found. No gross changes in Tregs were present. T lymphocyte activation was maximal 1 and 2 months after PHI, and significantly decreased in the following period. The level of activation two months after PHI was strictly correlated to the plasma viral load 1 year after infection, and significantly influenced the length of period without therapy. Indeed, 80% of patients with less than the median value of activated CD8+ (15.5%) or CD4+ (0.9%) T cells remained free of therapy for >46 months, while all patients over the median value had to start treatment within 26 months.
  
  
  CONCLUSIONS
  T cell activation after PHI, more than T cell polyfunctionality or Tregs, is a predictive marker for the control of viral load and for the time required to start treatment.
authors.affiliation: Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy. andrea.cossarizza@unimore.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Cossarizza
authors.forename: Linda
authors.initials: L
authors.lastname: Bertoncelli
authors.forename: Elisa
authors.initials: E
authors.lastname: Nemes
authors.forename: Enrico
authors.initials: E
authors.lastname: Lugli
authors.forename: Marcello
authors.initials: M
authors.lastname: Pinti
authors.forename: Milena
authors.initials: M
authors.lastname: Nasi
authors.forename: Sara
authors.initials: S
authors.lastname: De Biasi
authors.forename: Lara
authors.initials: L
authors.lastname: Gibellini
authors.forename: Jonas P
authors.initials: JP
authors.lastname: Montagna
authors.forename: Marco
authors.initials: M
authors.lastname: Vecchia
authors.forename: Lisa
authors.initials: L
authors.lastname: Manzini
authors.forename: Marianna
authors.initials: M
authors.lastname: Meschiari
authors.forename: Vanni
authors.initials: V
authors.lastname: Borghi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Cristina
authors.initials: C
authors.lastname: Mussini
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008213:Lymphocyte Activation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents