The effect of commencing combination antiretroviral therapy soon after human immunodeficiency virus type 1 infection on viral replication and antiviral immune responses.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

The effect of commencing combination antiretroviral therapy soon after human immunodeficiency virus type 1 infection on viral replication and antiviral immune responses.

J Infect Dis. 1999 Mar;179(3):527-37. Unique Identifier : AIDSLINE MED/99137787
Markowitz M; Vesanen M; Tenner-Racz K; Cao Y; Binley JM; Talal A; Hurley A; Ji X; Chaudhry MR; Yaman M; Frankel S; Heath-Chiozzi M; Leonard JM; Moore JP; Racz P; Nixon DF; Ho DD; Aaron Diamond AIDS Research Center, Rockefeller University, New; York, NY 10016, USA. marty@adarc.org

Abstract: Twelve subjects were treated with zidovudine, lamivudine, and ritonavir within 90 days of onset of symptoms of acute infection to determine whether human immunodeficiency virus type 1 (HIV-1) infection could be eradicated from an infected host. In adherent subjects, with or without modifications due to intolerance, viral replication was suppressed during the 24-month treatment period. Durable suppression reduced levels of HIV-1-specific antibodies and cytotoxic T lymphocyte responses in selected subjects. Proviral DNA in mononuclear cells uniformly persisted. The persistence of HIV-1 RNA expression in lymphoid tissues and peripheral blood mononuclear cells suggests that elimination of this residual pool of virus should be achieved before considering adjustments in antiretroviral therapeutic regimens. In addition, given the reduction in levels of virus-specific immune responses, it would seem prudent to consider enhancing these responses using vaccine strategies prior to the withdrawal of antiviral therapy.

Keywords: CLINICAL TRIAL JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/*DRUG THERAPY/IMMUNOLOGY/ VIROLOGY Adult Anti-HIV Agents/*THERAPEUTIC USE Drug Therapy, Combination Homosexuality, Male Human HIV-1/DRUG EFFECTS/IMMUNOLOGY/*PHYSIOLOGY Lamivudine/*THERAPEUTIC USE Male Middle Age Pilot Projects Ritonavir/*THERAPEUTIC USE RNA, Viral/BLOOD Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. T-Lymphocytes, Cytotoxic/IMMUNOLOGY Time Factors Viremia/BLOOD/DRUG THERAPY Virus Replication/*DRUG EFFECTS Zidovudine/*THERAPEUTIC USE
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A9960920

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