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Incomplete HIV Type 1 Antibody Evolution and Seroreversion in Acutely Infected Individuals Treated with Early Antiretroviral Therapy.
- Source :
- Clinical Infectious Diseases; 3/15/2005, Vol. 40 Issue 6, p868-873, 6p
- Publication Year :
- 2005
-
Abstract
- Background. The diagnosis of human immunodeficiency virus type 1 (HIV-1) infection by standard tests relies on the formation of HIV- 1-specific antibodies. Early treatment of acute HIV- 1 infection may have unique immunologic effects on host cellular and humoral responses. Rare cases of HIV- 1 seroreversion have been reported for patients with advanced or rapidly progressive disease. Here, we report seroreversion that occurred in subjects with acute HIV- 1 infection who initiated early antiretroviral therapy. Methods. A total of 150 patients with symptomatic acute or early onset HIV- 1 infection that was treated with antiretroviral therapy were observed prospectively by means of monthly clinical and laboratory evaluation, which included serial HIV enzyme-linked immunosorbent assay and Western blots, until a fully evolved HIV-1 antibody response was documented. Results. Three patients who initiated antiretroviral therapy a mean interval of 8 days (range, 1-16 days) after presentation and were observed for a mean duration of 50.2 months (range, 40.2-55.7 months) did not develop a fully evolved HIV- 1 antibody response or demonstrated complete or partial HIV- 1 seroreversion, despite maintenance of cytomegalovirus-specific humoral responses. Virologic suppression and seroreversion (complete or partial) occurred a mean duration of 4.1 months (range, 2.3-5.7 months) and 15.5 months (range, 6.7-26.3 months), respectively, after the initiation of therapy. All patients maintained complete virologic suppression while receiving therapy and had an undetectable HIV- 1 RNA load at the time of seroreversion. Conclusions. Early antiretroviral therapy associated with durable virologic suppression in acute HIV- 1 infection may abrogate the formation or detection of HIV- 1-specific antibodies. Ongoing antigenic stimulation may be required to maintain HIV- 1-specific humoral responses. Incomplete evolution of the HIV- 1 antibody response and/or presence of seroreversion (although infrequently observed) underscore the potential unique immunologic effect of early antiretroviral therapy in patients with primary HIV- 1 infection. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV
HTLV
ENZYME-linked immunosorbent assay
NUCLEIC acids
IMMUNOGLOBULINS
RNA
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 40
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 16261150
- Full Text :
- https://doi.org/10.1086/428127