Rapid Clinical Progression and Its Correlates Among Acute HIV Infected Men Who Have Sex With Men in China： Findings From a 5-Year Multicenter Prospective Cohort Study

BackgroundIn the “treat all” era, there are few data on the nature of HIV clinical progression in middle-income countries. The aim of the current study was to prospectively analyze the clinical progression of HIV and its indicators among men in China with acute HIV who have sex with men.MethodsFrom 2009–2014 a total of 400 men with acute HIV infection (AHI) were identified among 7,893 men who have sex with men via periodic pooled nucleic acid amplification testing, and they were assigned to an AHI prospective cohort in Beijing and Shenyang, China. Rapid progression was defined as two consecutive CD4+ T cell counts < 350/µL within 3–24 months post-infection. Kaplan−Meier and Cox-regression analyses were conducted to identify predictors of rapid progression.ResultsAmong 400 men with AHI 46.5% were rapid progressors, 35.1% reached rapid progressor status by 12 months post-infection, and 63.9% reached rapid progressor status by 24 months. Rapid progression was associated with herpes simplex-2 virus coinfection (adjusted hazard ratio [aHR] 1.7, 95% confidence interval [CI] 1.2–2.3], depression (aHR 1.9, 95% CI 1.5–2.6), baseline CD4+ T cell count < 500/μL (aHR 3.5, 95% CI 2.4–5.1), higher baseline HIV viral load (aHR 1.6, 95% CI 1.2–2.3), acute symptoms lasting ≥ 2 weeks (aHR 1.6, 95% CI 1.1–2.2), higher body mass index (aHR 0.9, 95% CI 0.9–1.0), higher HIV viral load (aHR 1.7, 95% CI 1.4–2.1), set point viral load at 3 months (aHR 2.0, 95% CI 1.6–2.5), each 100-cell/μL decrease in CD4+ T cell count at 3 months (aHR 2.2, 95% CI 1.9–2.5), and baseline routine blood tests including white blood cell count < 5.32, hemoglobin ≥ 151, mean corpuscular hemoglobin ≥ 30.5, hemoglobin concentration ≥ 342, mean platelet count ≥ 342, lymphocytes ≥ 1.98, and mixed cell count ≥ 0.4 (all p < 0.05).ConclusionAlmost half of the patients underwent rapid clinical progression within 2 years after HIV infection. A treat-all policy is necessary and should be strengthened globally. Rapid progression was correlated with herpes simplex-2 virus coinfection, depression, low CD4+ T cell counts, and high set point viral load in acute infection stage. Rapid progression can be identified via simple indicators such as body mass index and routine blood test parameters in low and middle-income countries.

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Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naïve Mozambican patients

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.008401 ◽

2009 ◽

Vol 20 (12) ◽

pp. 863-868 ◽

Cited By ~ 14

Author(s):

N B Bhatt ◽

E S Gudo ◽

C Semá ◽

D Bila ◽

P Di Mattei ◽

...

Keyword(s):

Viral Load ◽

T Cell ◽

Cd4 T Cell ◽

Hiv Viral Load ◽

Cell Counts ◽

Treatment Naïve

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CD8+T-Cells Count in Acute Myocardial Infarction in HIV Disease in a Predominantly Male Cohort

BioMed Research International ◽

10.1155/2015/246870 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Oluwatosin A. Badejo ◽

Chung-Chou Chang ◽

Kaku A. So-Armah ◽

Russell P. Tracy ◽

Jason V. Baker ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

T Cell ◽

Cell Count ◽

Hiv Viral Load ◽

Cvd Risk ◽

Infected People ◽

Cell Counts ◽

Immunodeficiency Virus ◽

Male Cohort

Human Immunodeficiency Virus- (HIV-) infected persons have a higher risk for acute myocardial infarction (AMI) than HIV-uninfected persons. Earlier studies suggest that HIV viral load, CD4+T-cell count, and antiretroviral therapy are associated with cardiovascular disease (CVD) risk. Whether CD8+T-cell count is associated with CVD risk is not clear. We investigated the association between CD8+T-cell count and incident AMI in a cohort of 73,398 people (of which 97.3% were men) enrolled in the U.S. Veterans Aging Cohort Study-Virtual Cohort (VACS-VC). Compared to uninfected people, HIV-infected people with high baseline CD8+T-cell counts (>1065 cells/mm3) had increased AMI risk (adjustedHR=1.82, P<0.001, 95% CI: 1.46 to 2.28). There was evidence that the effect of CD8+T-cell tertiles on AMI risk differed by CD4+T-cell level: compared to uninfected people, HIV-infected people with CD4+T-cell counts ≥200 cells/mm3had increased AMI risk with high CD8+T-cell count, while those with CD4+T-cell counts <200 cells/mm3had increased AMI risk with low CD8+T-cell count. CD8+T-cell counts may add additional AMI risk stratification information beyond that provided by CD4+T-cell counts alone.

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Factors Associated with Immune Discordant Responses in Treated HIV-infected Omani Patients

The Open AIDS Journal ◽

10.2174/1874613601913010025 ◽

2019 ◽

Vol 13 (1) ◽

pp. 25-30

Author(s):

Zied Gaifer Ali ◽

Mohamed-Rachid Boulassel

Keyword(s):

T Cell ◽

Cell Count ◽

Opportunistic Infections ◽

Significant Proportion ◽

Hiv Viral Load ◽

Viral Control ◽

Logistic Regression Models ◽

Factors Associated ◽

Cell Counts ◽

The Impact

Background: Despite sustained viral control by antiretroviral therapy (ART), some HIV-infected patients do not recover normal CD4+ T cell counts. This Discordant Immune Response (DIR) increases the risk of opportunistic infections. Objective: To evaluate the factors associated with DIR in HIV-infected Omani patients attending public sector clinics. Methods: All HIV-infected patients receiving ART with regular follow-up visits were eligible for this study. The DIR group comprised patients on ART for at least two years with plasma HIV viral load < 50 copies/mL and helper CD4+ T cell counts below 350 cells/μl. The Concordant Immune Responses (CIR) group was similar to DIR but with CD4+ T cell counts above 350 cells/μl. Univariate and multivariate analyses using logistic regression models were used to assess the impact of demographic characteristics, clinical, immunological and virological parameters, type of ART regimens, tuberculosis and other opportunistic co-infections on DIR. Results: Among 153 enrolled participants, 28 and 76 patients were identified as having DIR and CIR, respectively. The multivariate analysis revealed that the only factors independently associated with DIR after adjustment were age (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.04-1.23), baseline CD4+ T cell count (OR: 0.98; CI: 0.97-0.99) and baseline CD56+ cell count (OR: 0.97; CI: 0.96-0.99). Conclusion: Collectively, these findings suggest that a significant proportion of HIV-infected Omani patients develop DIR totaling 27%, and efforts should be made to improve early identification of these patients who tend to experience poor clinical outcomes.

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Cluster of differentiation 4+ T-cell counts and human immunodeficiency virus-1 viral load in patients coinfected with hepatitis B virus and hepatitis C virus

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_37_17 ◽

2018 ◽

Vol 10 (02) ◽

pp. 162-167

Author(s):

Sakshee Gupta ◽

Bharti Malhotra ◽

Jitendra Kumar Tiwari ◽

Prabhu Dayal Khandelwal ◽

Rakesh Kumar Maheshwari

Keyword(s):

Viral Load ◽

T Cell ◽

Hepatitis B ◽

Cd4 T Cell ◽

Hiv Viral Load ◽

Cell Counts ◽

B Virus ◽

Immunodeficiency Virus ◽

Cluster Of Differentiation ◽

Hiv 1

ABSTRACT BACKGROUND: Coinfections of human immunodeficiency virus (HIV) with hepatitis viruses may affect the progress of disease and response to therapy. OBJECTIVES: To study the incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfections in HIV–positive patients and their influence on HIV–1 viral load and cluster of differentiation 4+ (CD4+) T–cell counts. MATERIALS AND METHODS: This pilot study was done on 179 HIV–positive patients attending antiretroviral therapy (ART) centre. Their blood samples were tested for HIV-1 viral load, CD4+ T–cell counts, hepatitis B surface antigen, anti–HCV antibodies, HBV DNA and HCV RNA polymerase chain reaction. RESULTS: Among the 179 patients, 7.82% (14/179) were coinfected with HBV and 4.46% (8/179) with HCV. Median CD4+ T–cell count of HIV monoinfected patients was 200 cells/µl and viral load was 1.67 log10 copies/µl. Median CD4+ T–cell counts of 193 cells/µl for HBV (P = 0.230) and 197 cells/µl for HCV (P = 0.610) coinfected patients were similar to that of HIV monoinfected patients. Viral load was higher in both HBV and HCV infected patients but statistically significant only for HCV (P = 0.017). Increase in CD4+ T–cell counts and decrease in HIV–1 viral load in coinfected patients on 2 years of ART were lower than that in HIV monoinfected patients. CONCLUSION: HBV/HCV coinfected HIV patients had similar CD4+ T–cell counts as in HIV monoinfected patients, higher HIV viral load both in chemo–naive patients and in those on ART as compared to HIV monoinfected patients. However, this study needs to be done on a large scale to assess the impact of coinfection on CD4 count and HIV viral load with proper follow–up of patients every 6 months till at least 2 years.

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Smaller limbic structures are associated with greater immunosuppression in over 1000 HIV-infected adults across five continents: Findings from the ENIGMA-HIV Working Group

10.1101/724583 ◽

2019 ◽

Cited By ~ 1

Author(s):

Talia M. Nir ◽

Jean-Paul Fouche ◽

Jintanat Ananworanich ◽

Beau M. Ances ◽

Jasmina Boban ◽

...

Keyword(s):

Viral Load ◽

T Cell ◽

Hiv Infection ◽

Cell Count ◽

Working Group ◽

Cd4 T Cell ◽

Hiv Viral Load ◽

Subcortical Brain ◽

Cd4 T Cell Count

AbstractBackgroundHuman immunodeficiency virus type-1 (HIV) infection can be controlled with combination antiretroviral therapy (cART), but neurocognitive impairment remains common even in chronic and treated HIV-infected (HIV+) cohorts. Identifying the neuroanatomical pathways associated with infection has the potential to delineate novel neuropathological processes underlying persisting deficits, yet individual neuroimaging studies have yielded inconsistent findings. The ENIGMA-HIV Working Group was established to harmonize data from diverse studies to identify the common effects of HIV-infection on brain structure.MethodsData were pooled from 12 independent neuroHIV studies from Africa, Asia, Australia, Europe, and North America. Volume estimates for eight subcortical brain regions were extracted from T1-weighted MRI from 1,044 HIV+ adults (aged 22-81 years; 72.4% on cART; 70.3% male; 41.6% with detectable viral load (dVL)), to identify associations with plasma markers reflecting current immunosuppression (CD4+ T-cell count) or dVL. Follow-up analyses stratified data by cART status and sex. Bonferroni correction was used to determine statistical significance.FindingsLower current CD4+ count was associated with smaller hippocampal (β = 20.3 mm3 per 100 cells/mm3; p = 0.0001) and thalamic volumes (β = 29.3; p = 0.003); in the subset of participants not on cART, it was associated with smaller putamen volumes (β = 65.1; p = 0.0009). On average, a dVL was associated with smaller hippocampal (Cohen’s d = 0.24; p = 0.0003) and amygdala volumes (d = 0.18; p = 0.0058).InterpretationIn HIV+ individuals across five continents, smaller limbic volumes were consistently associated with current plasma markers. As we assessed cohorts with different inclusion/exclusion criteria and demographic distributions, these deficits may represent a generalizable brain-signature of HIV infection in the cART era. Our findings support the importance of achieving viral suppression and immune restoration for maintaining brain health.FundingThis work was supported, in part, by NIH grant U54 EB020403.Research in ContextEvidence before this studyHIV type-1 infection can be managed with antiretroviral therapy, however neurocognitive impairment persists even in treated HIV+ individuals. Given the challenges associated with standardized cognitive testing, there is a need to identify quantitative markers of central nervous system impairment. A number of neuroimaging studies have reported brain abnormalities in HIV-infected patients; however, prior studies investigating associations between CD4+ T-cell count or HIV viral load and subcortical brain volume report variable effect sizes and regional distributions of effects, limiting the generalizability of the conclusions drawn to date. We have conducted a literature search for reports in English language journals published until June 2019, using the following search terms: HIV AND subcortical AND neuroimaging AND brain AND viral load AND RNA AND CD4. After removing studies that were not applicable, there were 30 studies investigating CD4+ T-cell count and viral load associations with subcortical brain structure.Added value of the studyThe aim of the current study was to investigate structural brain associations with two biomarkers universally used to monitor immune function and treatment response, namely plasma RNA viral load and CD4+ T-cell counts. Prior analyses have been performed in smaller, heterogeneous cohorts, but by combining data across cohorts, we can identify consistent associations between brain volume and indicators of HIV infection across cohorts. The ENIGMA-HIV Working Group was established to identify common neurobiological signatures of the HIV-infected brain by harmonizing data analysis from HIV neuroimaging studies worldwide. The value of this dataset is that it is well-powered and representative of many HIV+ people living in the cART era.Implications of all the available evidenceOur results provide robust evidence that despite demographic and clinical heterogeneity among HIV-infected individuals, brain abnormalities are consistently linked to HIV viral load and immunosuppression. This supports the importance of achieving viral suppression and immune system restoration in maintaining brain health in people living with HIV. The vulnerability of limbic regions, found in this study, extends beyond the classically implicated regions of the basal ganglia; this suggests that these regions remain an important target of cART era HIV research, especially given their heightened vulnerability to age-associated atrophy and neurodegeneration.

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PO 8481 HIGH HEPATITIS B VIRUS INCIDENCE AMONG HIV-1-INFECTED TREATMENT-NAIVE ADULTS IN BOTSWANA

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.115 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A44.1-A44

Author(s):

Bonolo B Phinius ◽

Resego Bokete ◽

Motswedi Anderson ◽

Tshepiso Mbangiwa ◽

Wonderful Choga ◽

...

Keyword(s):

Viral Load ◽

Hepatitis B Virus ◽

T Cell ◽

Hepatitis B ◽

Cell Count ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

B Virus ◽

Treatment Naïve ◽

Hiv 1

BackgroundHepatitis B virus (HBV) is one of the leading causes of death worldwide despite a moderately potent vaccine. HBV prevalence has been shown to be higher in patients infected with the human immunodeficiency virus (HIV), hence increased liver-related morbidity and mortality, as well as general poor health outcomes in HIV-HBV co-infection. We estimated the HBV incidence among HIV-1-infected treatment-naïve adults in a longitudinal cohort in Botswana.MethodsPlasma samples from 200 HIV-1C-infected treatment-naïve participants from a completed longitudinal cohort from 2004 to 2007 were screened for HBV surface antigen (HBsAg). HBsAg was assessed using Murex version 3 enzyme-linked immunosorbent assay as per manufacturer’s instructions at 4 timepoints, 12 months apart. We estimated HBV incidence with 95% confidence interval (CI). Cox proportional regression method was used to estimate hazard ratios [gender, age (≤35 or>35) years, CD4+ T cell count (≤450 or>450) cells/µL and HIV viral load suppression (≤400 or>400) copies/mL].ResultsThe median age of screened individuals was 32 years [Q1, Q3; 28, 40] and 83.5% [167/200] were female. Baseline median CD4+ T cell count was 466.35 cells/µL [Q1, Q3: 380.43, 605.75] and median HIV viral load was 13 450 copies/mL [Q1, Q3: 2365, 37 400]. The HBV incidence was 3.6/100 person-years [95% CI: 2.2–5.6]. There were no significant differences by gender, age, HIV viral load suppression and CD4+ T cell count.ConclusionWe report for the first time a high HBV incidence among HIV-infected adults in Botswana. HBV incidence was high in this population despite generally high CD4 +T cell counts and lower HIV viral loads. Early screening of HBV in HIV-infected individuals is vital and should be included in the national HIV treatment guidelines.

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Impact of HLA Allele-KIR Pairs on HIV Clinical Outcome in South Africa

The Journal of Infectious Diseases ◽

10.1093/infdis/jiy692 ◽

2018 ◽

Vol 219 (9) ◽

pp. 1456-1463 ◽

Cited By ~ 4

Author(s):

Masahiko Mori ◽

Ellen Leitman ◽

Bruce Walker ◽

Thumbi Ndung’u ◽

Mary Carrington ◽

...

Keyword(s):

South Africa ◽

Viral Load ◽

T Cell ◽

Clinical Outcome ◽

Nk Cells ◽

Cd4 T Cell ◽

Rapid Progression ◽

Immune Control ◽

Cell Counts ◽

Significant Difference

Abstract Background HLA class I contributes to HIV immune control through antigen presentation to cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells. In contrast to investigations of CTL, studies of NK cells in HIV control through HLA-killer immunoglobulin-like receptor (KIR) interactions remain sparse in African cohorts. Methods Treatment-naive, chronically HIV-infected adults (N = 312) were recruited from South Africa, and the effects of HLA-KIR pairs on clinical outcome were analyzed. Results There was no significant difference in viral load among all subjects with HLA alleles from the HLA-C1 group (P = .1). However, differences in HLA-C type significantly influenced viremia among 247 KIR2DL3 positives (P = .04), suggesting that specific HLA-KIR interactions contribute to immune control. Higher viral load (P = .02) and lower CD4+ T-cell counts (P = .008) were observed in subjects with HLA-C*16:01+KIR2DL3+. Longitudinal analysis showed more rapid progression to AIDS among HLA-C*16:01+KIR2DL3+ subjects (adjusted hazard ratio 1.9, P = .03) than those without this genotype, independent of CD4+ T-cell count and viral load. Conclusions These results highlight the existence of unique anti-HIV innate immunity within distinct populations and the contribution of KIR on NK cells and some CTLs to the well-described HLA-mediated impact on HIV disease progression.

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Efficacy and safety of human papillomavirus vaccination in HIV-infected patients: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-83727-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Antonella Zizza ◽

Federico Banchelli ◽

Marcello Guido ◽

Claudia Marotta ◽

Francesco Di Gennaro ◽

...

Keyword(s):

Systematic Review ◽

Viral Load ◽

T Cell ◽

Adverse Events ◽

Cell Count ◽

Hpv Vaccine ◽

Cd4 T Cell ◽

Efficacy And Safety ◽

Hiv Viral Load ◽

Cd4 T Cell Count

AbstractThe prophylactic vaccines available to protect against infections by HPV are well tolerated and highly immunogenic. People with HIV have a higher risk of developing HPV infection and HPV-associated cancers due to a lower immune response, and due to viral interactions. We performed a systematic review of RCTs to assess HPV vaccines efficacy and safety on HIV-infected people compared to placebo or no intervention in terms of seroconversion, infections, neoplasms, adverse events, CD4+ T-cell count and HIV viral load. The vaccine-group showed a seroconversion rate close to 100% for each vaccine and a significantly higher level of antibodies against HPV vaccine types, as compared to the placebo group (MD = 4333.3, 95% CI 2701.4; 5965.1 GMT EL.U./ml for HPV type 16 and MD = 1408.8, 95% CI 414.8; 2394.7 GMT EL.U./ml for HPV type 18). There were also no differences in terms of severe adverse events (RR = 0.6, 95% CI 0.2; 1.6) and no severe adverse events (RR = 0.6, 95% CI 0.9; 1.2) between vaccine and placebo groups. Secondary outcomes, such as CD4 + T-cell count and HIV viral load, did not differ between groups (MD = 14.8, 95% CI − 35.1; 64.6 cells/µl and MD = 0.0, 95% CI − 0.3; 0.3 log10 RNA copies/ml, respectively). Information on the remaining outcomes was scarce and that did not allow us to combine the data. The results support the use of the HPV vaccine in HIV-infected patients and highlight the need of further RCTs assessing the effectiveness of the HPV vaccine on infections and neoplasms.

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Naïve CD4+ cell counts significantly decay and high HIV RNA levels contribute to immunological progression in long-term non-progressors infected with HIV by blood products: a cohort study

BMC Immunology ◽

10.1186/s12865-021-00426-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ling Xu ◽

Yubin Liu ◽

Xiaojing Song ◽

Yanling Li ◽

Yang Han ◽

...

Keyword(s):

Viral Load ◽

T Cell ◽

Cell Count ◽

Blood Products ◽

Hiv Rna ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Rna Levels

Abstract Background Some long-term non-progressors (LTNPs) have decreasing CD4+ T cell counts and progress to AIDS. Exploring which subsets of CD4+ T cell decreasing and the determinants associated with the decay in these patients will improve disease progression surveillance and provide further understanding of HIV pathogenesis. Methods Twenty-five LTNPs infected with HIV by blood products were classified as decreased (DG) if their CD4+ cell count dropped to < 400 cells/μL during follow-up or as non-decreased (non-DG) if their CD4+ cell count was ≥400 cells/μL. Laboratory and clinical assessments were conducted at 6 consecutive visits to identify DG characteristics. Results The LTNPs were infected with HIV for 12 (IQR: 11.5–14) years, and 23 were classified as the B′ subtype. Six individuals lost LTNP status 14.5 (IQR: 12.5–17.5) years after infection (DG), and the CD4+ T cell count decreased to 237 (IQR: 213–320) cells/μL at the latest visit. The naïve CD4+ T cell count decrease was greater than that of memory CD4+ T cells [− 128 (IQR: − 196, − 107) vs − 64 (IQR: − 182, − 25) cells/μL)]. Nineteen individuals retained LTNP status (non-DG). At enrolment, the viral load (VL) level (p = 0.03) and CD8+CD38+ percentage (p = 0.03) were higher in DG than non-DG individuals. During follow-up, viral load and CD8+CD38+ percentage were significantly increased and negatively associated with CD4+ cell count [(r = − 0.529, p = 0.008), (r = − 0.476, p = 0.019), respectively]. However, the CD8+CD28+ percentage and B cell count dropped in DG and were positively correlated with CD4+ T cell count [(r = 0.448, p = 0.028), (r = 0.785, p < 0.001)]. Conclusion Immunological progression was mainly characterized by the decrease of naïve CD4+ T cell in LTNPs infected with HIV by blood products and it may be associated with high HIV RNA levels.

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Longitudinal Analysis of Peripheral and Colonic CD161+ CD4+ T Cell Dysfunction in Acute HIV-1 Infection and Effects of Early Treatment Initiation

Viruses ◽

10.3390/v12121426 ◽

2020 ◽

Vol 12 (12) ◽

pp. 1426

Author(s):

Kerri Lal ◽

Yuwadee Phuang-Ngern ◽

Suchada Suhkumvittaya ◽

Edwin Leeansyah ◽

Aljawharah Alrubayyi ◽

...

Keyword(s):

T Cells ◽

Viral Load ◽

T Cell ◽

Cell Population ◽

Peripheral Blood ◽

Cd4 T Cells ◽

Cd4 T Cell ◽

Cell Counts ◽

Acute Hiv ◽

Hiv 1

CD161 expression on CD4+ T cells is associated with a Th17 functional phenotype, as well as with an innate capacity to respond to interleukin (IL)-12 and IL-18 without T cell receptor (TCR) stimulation. Chronic HIV-1 infection is associated with loss of the CD161+ CD4 T cell population, and non-human primate studies suggest that their depletion is associated with disease progression. However, the dynamics of the CD161+ CD4+ T cell population during acute HIV-1 infection remains unknown. In this study, we characterize peripheral blood CD161+ CD4+ T cells in detail, and examine how they are affected during the earliest stages of HIV-1 infection. Unbiased surface proteome screening and principal component analysis indicated that CD161+ CD4+ T cells are relatively phenotypically homogeneous between donors, and are intermediates between conventional CD4 T cells and innate-like T cells. In acute untreated HIV-1 infection, the circulating CD161+ CD4+ T cell population decreased in frequency, as did absolute cell counts starting from peak viral load, with elevated levels of activation and exhaustion markers expressed throughout acute HIV-1 infection. The capacity of these cells to respond to stimulation with IL-12 and IL-18 was also reduced. Early initiation of anti-retroviral treatment (ART) during acute HIV-1 infection restored the functionality of peripheral blood CD161+ CD4+ T cells, but not their frequency. In contrast, early ART initiation prevented the decline of colonic CD161+ CD4+ T cells that otherwise started during acute infection. Furthermore, loss of peripheral and colonic CD161+ CD4+ T cells in untreated infection was associated with levels of viral load. These results suggest that acute HIV-1 infection has profound effects on the CD161+ CD4+ T cell population that could not be completely prevented by the initiation of ART.

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