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Highly active antiretroviral therapy (HAART) has been advocated for the management of primary HIV-1 infection without clear understanding of its immunological effects. Here, we demonstrate that early use of HAART during primary infection preserves HIV-specific CD8(+) T cells physically and functionally while HIV-specific T cell help is sustained. We also show that even transient administration of HAART at seroconversion can preserve HIV-specific immunity. In contrast, delayed initiation of HAART is associated with a progressive loss of HIV-specific CD8(+) T cells and absent HIV-specific T cell help. These results imply that HIV-specific T help is damaged during primary HIV-1 infection. Early drug treatment, which preserves this immunity, also preserves HIV-specific CD8(+) T cells. These results have implications for understanding the early pathogenesis of HIV-1 infection and suggest that acute HIV infection should be treated aggressively and as early as possible.

Original publication




Journal article


Proc Natl Acad Sci U S A

Publication Date





3382 - 3387


Amino Acid Sequence, Anti-HIV Agents, Base Sequence, CD4-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes, DNA Primers, Epitopes, HIV Infections, HIV-1, HLA-B8 Antigen, Humans, Viral Load