Temporal association of cellular immune responses with the initial control of viremia in primary human immunodeficiency virus type 1 syndrome

TLDR

The study performed virologic and immunologic analyses on five patients with primary HIV‑1 infection. Early HIV‑1–specific CTL precursors were detected in most patients, and the single patient lacking an initial CTL response experienced prolonged viremia and low CD4+ counts, indicating that cellular immunity contributes to early viral control.

Abstract

Virologic and immunologic studies were performed on five patients presenting with primary human immunodeficiency virus type 1 (HIV-1) infection. CD8+ cytotoxic T lymphocyte (CTL) precursors specific for cells expressing antigens of HIV-1 Gag, Pol, and Env were detected at or within 3 weeks of presentation in four of the five patients and were detected in all five patients by 3 to 6 months after presentation. The one patient with an absent initial CTL response had prolonged symptoms, persistent viremia, and low CD4+ T-cell count. Neutralizing antibody activity was absent at the time of presentation in all five patients. These findings suggest that cellular immunity is involved in the initial control of virus replication in primary HIV-1 infection and indicate a role for CTL in protective immunity to HIV-1 in vivo.