Immune activation during acute HIV infection and the impact of early antiretroviral therapy

2016 ◽  
Vol 11 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Shelly J. Krebs ◽  
Jintanat Ananworanich
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Activation ◽  
Acute Hiv Infection ◽  
Acute Hiv ◽  
The Impact

scholarly journals Very Early Initiation of Antiretroviral Therapy During Acute HIV Infection Is Associated With Normalized Levels of Immune Activation Markers in Cerebrospinal Fluid but Not in Plasma

2019 ◽  
Vol 220 (12) ◽  
pp. 1885-1891 ◽  
Author(s):  
Joanna Hellmuth ◽  
Bonnie M Slike ◽  
Carlo Sacdalan ◽  
John Best ◽  
Eugene Kroon ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Activation ◽  
Acute Hiv Infection ◽  
Activation Markers ◽  
Art Initiation ◽  
Markers Of Inflammation ◽  
Median Plasma ◽  
Acute Hiv

Abstract Background Chronic immune activation in the blood and central nervous system is a consequence of human immunodeficiency virus (HIV) infection that contributes to disease morbidity and can occur despite virally suppressive antiretroviral therapy (ART). The trajectory of HIV-related inflammation may vary with the timing of ART initiation. We examined immune activation markers in cerebrospinal fluid (CSF) and blood specimens collected over 96 weeks from participants who initiated ART during acute HIV infection (AHI). Methods RV254/SEARCH010 study participants with AHI underwent CSF (n = 89) and plasma (n = 146) sampling before initiating ART and at weeks 24 and 96 of treatment. A majority participants (64.4%) received a standard ART regimen (hereafter, “standard ART”), with some (34.7%) also receiving maraviroc and raltegravir for the first 24 weeks (hereafter, “ART plus”). We compared neopterin, CXCL10, CCL2, and interleukin 6 (IL-6) levels in the AHI group to those in 18 healthy, uninfected controls. Results Following 24 and 96 weeks of treatment, levels of all CSF markers normalized while levels of several plasma markers remained elevated in the AHI group (P < .001). Participants receiving the ART-plus regimen had lower median plasma CCL2 levels at week 24 and lower plasma neopterin levels at week 96. Conclusions ART initiation during AHI differentially impacts the brain compartment, with markers of inflammation returning to normal levels in the CSF, where they were sustained at week 96, but not in plasma.

scholarly journals Protective HLA alleles are associated with reduced LPS levels in acute HIV infection with implications for immune activation and pathogenesis

2019 ◽  
Vol 15 (8) ◽  
pp. e1007981 ◽  
Author(s):  
Daniel T. Claiborne ◽  
Eileen P. Scully ◽  
Christine D. Palmer ◽  
Jessica L. Prince ◽  
Gladys N. Macharia ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Immune Activation ◽  
Acute Hiv Infection ◽  
Hla Alleles ◽  
Acute Hiv

scholarly journals The impact of immunoglobulin in acute HIV infection on the HIV reservoir: a randomized controlled trial

HIV Medicine ◽  
2017 ◽  
Vol 18 (10) ◽  
pp. 777-781 ◽  
Author(s):  
J Tiraboschi ◽  
S Ray ◽  
K Patel ◽  
A Teague ◽  
M Pace ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hiv Infection ◽  
Controlled Trial ◽  
Acute Hiv Infection ◽  
Hiv Reservoir ◽  
Randomized Controlled ◽  
Acute Hiv ◽  
The Impact

scholarly journals Viral Dynamics of Acute HIV-1 Infection

1999 ◽  
Vol 190 (6) ◽  
pp. 841-850 ◽  
Author(s):  
Susan J. Little ◽  
Angela R. McLean ◽  
Celsa A. Spina ◽  
Douglas D. Richman ◽  
Diane V. Havlir
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Doubling Time ◽  
Basic Reproductive Number ◽  
Reproductive Number ◽  
Target Cells ◽  
Viral Dynamics ◽  
Acute Hiv Infection ◽  
Acute Hiv ◽  
The Mean

Viral dynamics were intensively investigated in eight patients with acute HIV infection to define the earliest rates of change in plasma HIV RNA before and after the start of antiretroviral therapy. We report the first estimates of the basic reproductive number (R0), the number of cells infected by the progeny of an infected cell during its lifetime when target cells are not depleted. The mean initial viral doubling time was 10 h, and the peak of viremia occurred 21 d after reported HIV exposure. The spontaneous rate of decline (α) was highly variable among individuals. The phase 1 viral decay rate (δI = 0.3/day) in subjects initiating potent antiretroviral therapy during acute HIV infection was similar to estimates from treated subjects with chronic HIV infection. The doubling time in two subjects who discontinued antiretroviral therapy was almost five times slower than during acute infection. The mean basic reproductive number (R0) of 19.3 during the logarithmic growth phase of primary HIV infection suggested that a vaccine or postexposure prophylaxis of at least 95% efficacy would be needed to extinguish productive viral infection in the absence of drug resistance or viral latency. These measurements provide a basis for comparison of vaccine and other strategies and support the validity of the simian immunodeficiency virus macaque model of acute HIV infection.

scholarly journals Efficacy, pharmacokinetics and neurocognitive performance of dual, NRTI-sparing antiretroviral therapy in acute HIV-infection

AIDS ◽  
2020 ◽  
Vol 34 (13) ◽  
pp. 1923-1931
Author(s):  
Cynthia L. Gay ◽  
Dayna T. Neo ◽  
Aaron S. Devanathan ◽  
Joann D. Kuruc ◽  
Kara S. McGee ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Neurocognitive Performance ◽  
Acute Hiv Infection ◽  
Acute Hiv

scholarly journals Efficacy of NNRTI-based antiretroviral therapy initiated during acute HIV infection

AIDS ◽  
2011 ◽  
pp. 1 ◽  
Author(s):  
Cynthia L Gay ◽  
Ashley J Mayo ◽  
Chelu K Mfalila ◽  
Haitao Chu ◽  
Anna C Barry ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Acute Hiv Infection ◽  
Acute Hiv

scholarly journals Normalization of Soluble CD163 Levels After Institution of Antiretroviral Therapy During Acute HIV Infection Tracks with Fewer Neurological Abnormalities

2018 ◽  
Vol 218 (9) ◽  
pp. 1453-1463 ◽  
Author(s):  
Michelle L D’Antoni ◽  
Mary Margaret Byron ◽  
Phillip Chan ◽  
Napapon Sailasuta ◽  
Carlo Sacdalan ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Acute Hiv Infection ◽  
Soluble Cd163 ◽  
Neurological Abnormalities ◽  
Acute Hiv

scholarly journals Decreased Seroreactivity in Individuals Initiating Antiretroviral Therapy during Acute HIV Infection

2019 ◽  
Vol 57 (10) ◽  
Author(s):  
Mark M. Manak ◽  
Linda L. Jagodzinski ◽  
Ashley Shutt ◽  
Jennifer A. Malia ◽  
Mike Leos ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Western Blot ◽  
Research Collaboration ◽  
Virologic Suppression ◽  
Infection Status ◽  
Acute Hiv Infection ◽  
Western Blot Assay ◽  
Acute Hiv ◽  
Hiv 1

ABSTRACTAntiretroviral therapy (ART) during acute HIV infection (AHI) interrupts viral dynamics and may delay the emergence of serological markers targeted by current HIV screening and confirmatory assays, thus creating challenges for correctly classifying HIV infection status. The performance of three HIV antigen/antibody combination (HIV Ag/Ab Combo) assays (the Bio-Rad GS, Abbott Architect, and Bio-Rad BioPlex 2200 assays) was evaluated with samples collected from RV254/South East Asia Research Collaboration in HIV 010 (RV254/SEARCH010) study (Bangkok, Thailand) participants at weeks 12 and 24 following the initiation of ART at Fiebig stage I (FI) (n = 23), FII (n = 39), or FIII/IV (n = 22). Supplemental, confirmatory testing was performed by the Geenius HIV 1/2 and HIV-1 Western blot assays (Bio-Rad). Samples from 30 untreated, HIV-1-infected individuals demonstrated robust HIV Ag/Ab Combo assay reactivity with well-developed HIV-1 Western blotting profiles by 24 weeks after infection. In contrast, 52.2% of samples from individuals initiating ART at FI, 7.7% of samples from individuals initiating ART at FII, and 4.5% of samples from individuals initiating ART at FIII/IV were nonreactive by the HIV Ag/Ab Combo assays, with 36.4 to 39.1% of samples having low signal-to-cutoff (S/CO) results by the Architect and BioPlex assays (S/CO < 10). Seroreversion from a reactive to a nonreactive status was observed in 10 individuals initiating ART at FII and 3 individuals initiating ART at FIII/IV. The Geenius and HIV-1 Western blot assay results were negative or indeterminate for 73.9% and 69.6% of individuals, respectively, treated at FI; 50.0% and 26.3% of individuals, respectively, treated at FII; and 54.5% and 40.9% of individuals, respectively, treated at FIII/IV. Virologic suppression of HIV-1 by ART during AHI impedes seroconversion to biomarkers of infection, limiting the utility of HIV Ag/Ab Combo and supplemental, confirmatory assays for infection status determination.

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