Immunological and virological responses in HIV-1-infected adults at early stage of established infection treated with highly active antiretroviral therapy

• Published in: AIDS (London) Vol. 14; no. 13; pp. 1887 - 1897
• Main Authors: BART, Pierre-Alexandre, RIZZARDI, G. Paolo, MEYLAN, Pascal, SPREEN, William, MCDADE, Hugh, YERLY, Sabine, PERRIN, Luc, LAZZARIN, Adriano, PANTALEO, Giuseppe, TAMBUSSI, Giuseppe, CHAVE, Jean-Philippe, CHAPUIS, Aude G, GRAZIOSI, Cecilia, CORPATAUX, Jean-Marc, HALKIC, Nermin, MEUWLY, Jean-Yves, MUNOZ, Miguel
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 08.09.2000
• Subjects: Adolescent; Adult; Aged; AIDS/HIV; Antiretroviral Therapy, Highly Active; Biological and medical sciences; Carbamates; CD4 antigen; CD4 Lymphocyte Count; CD4-CD8 Ratio; Dideoxynucleosides - therapeutic use; Female; highly active antiretroviral therapy; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV Protease Inhibitors - therapeutic use; HIV-1 - drug effects; HIV-1 - physiology; Human immunodeficiency virus 1; Human viral diseases; Humans; Infectious diseases; Lymph Nodes - immunology; Lymph Nodes - pathology; Lymphocyte Activation; Male; Medical sciences; Middle Aged; Prospective Studies; Reverse Transcriptase Inhibitors - therapeutic use; RNA, Viral - blood; Sulfonamides - therapeutic use; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Human; Immunopathology; HIV-1 virus; Treatment efficiency; Retroviridae; Immune reconstitution; AIDS; Early stage; Cellular immunity; Immune deficiency; Lentivirus; Infection; Virus; Chemotherapy; Immunological investigation; Viral disease; Adult; Antiviral; Human immunodeficiency virus; Viral load
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/00002030-200009080-00002

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