期刊
JOURNAL OF EXPERIMENTAL MEDICINE
卷 193, 期 2, 页码 169-180出版社
ROCKEFELLER UNIV PRESS
DOI: 10.1084/jem.193.2.169
关键词
cytotoxic T lymphocytes; T helper cell responses; viral evolution; cytotoxic T lymphocyte epitopes; human leukocyte antigen
资金
- NIAID NIH HHS [R01 AI30914, R01 AI040873, R37 AI028568, R01 AI44656, R01 AI044656, R01 AI030914, U01 AI041531, R37 AI28568] Funding Source: Medline
Immune responses induced during the early stages of chronic viral infections are thought to influence disease outcome. Using HIV as a model, we examined virus-specific cytotoxic T lymphocytes (CTLs), T helper cells, and viral genetic diversity in relation to duration of infection and subsequent response to antiviral therapy. Individuals with acute HIV-1 infection treated before seroconversion had weaker CTL responses directed at fewer epitopes than persons who were treated after seroconversion. However, treatment-induced control of viremia was associated with the development of strong T helper cell responses in both groups. After 1 yr of antiviral treatment initiated in acute or early infection, all epitope-specific CTL responses persisted despite undetectable viral loads. The breadth and magnitude of CTL responses remained significantly less in treated acute infection than in treated chronic infection, but viral diversity was also significantly less with immediate therapy. We conclude that early treatment of acute HIV infection leads to a more narrowly directed CTL response, stronger T helper cell responses, and a less diverse virus population. Given the need for T helper cells to maintain effective CTL responses and the ability of virus diversification to accommodate immune escape, we hypothesize that early therapy of primary infection may be beneficial despite induction of less robust CTL responses. These data also provide rationale for therapeutic immunization aimed at broadening CTL responses in treated primary HIV infection.
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