Initiation of antiretroviral therapy during acute HIV-1 infection may prevent persistent immune activation. We analyzed longitudinal CD38+HLA-DR+ CD8+ T-cell percentages in 31 acutely infected individuals who started early (median 43 days since infection) and successful antiretroviral therapy, and maintained viral suppression through 96 weeks. Pretherapy a median of 72.6% CD8+ T cells were CD38+HLA-DR+, and although this decreased to 15.6% by 96 weeks, it remained substantially higher than seronegative controls (median 8.9%, P = 0.008). Shorter time to suppression predicted lower activation at 96 weeks. These results support the hypothesis that very early events in HIV-1 pathogenesis may result in prolonged immune dysfunction.
*Department of Medicine, Center for Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC;
the Departments of †Surgery and
‡Medicine, Duke University, Durham, NC; and
§Department of Medicine, Emory University, Atlanta, GA.
Correspondence to: Michael J. Vinikoor, MD, Center for Infectious Diseases, University of North Carolina, 130 Mason Farm Road, CB #7030, 2nd Floor Bioinformatics, Chapel Hill NC 27599 (e-mail: firstname.lastname@example.org).
Supported by research contracts from Bristol-Myers Squibb, Gilead Sciences, and Janssen Therapeutics, and the following NIH-funded programs: UNC Center for AIDS Research (CFAR; 1P30 AI 50410-04), Duke CFAR (1P30 AI 64518), NCRR UL1TR000083, 5R01 AI050483, 5R13 AI084562, 2K24 AI01608 award, and 5T32 AI07001-35 award. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the article.
C.L.G. has received research support from Bristol-Myers Squibb, Gilead Sciences, and Janssen Therapeutics. C.B.H. has received grant support and/or consulting/honoraria from Bristol-Myers Squibb, GlaxoSmithKline/Viiv, Merck, Janssen Therapeutics, Gilead Sciences, Myriad, and Koronis. D.M.M. has received research support from Bristol-Myers Squibb, Gilead Sciences, and Merck, and honoraria from Bristol-Myers Squibb, Merck, Chimerix, and Janssen Therapeutics. J.J.E. receives research support from Bristol-Myers Squibb and GlaxoSmithKline and is a consultant to Bristol-Myers Squibb, Merck, GlaxoSmithKline/ViiV Healthcare, and Janssen Therapeutics. M.J.V., A.C., G.F., K.S.M., J.D.K., and J.L.L. have no conflicts of interest to disclose.
Received September 20, 2012
Accepted January 02, 2013