Acute HIV-1 Infection: Paradigm and Singularity.

Area of Science:

• Immunology
• Virology
• Infectious Diseases

Background:

• Acute HIV-1 infection (AHI) causes significant immune damage, including CD4+ T cell apoptosis and cytokine storm.
• HIV establishes persistent reservoirs by integrating viral DNA into host cells, evading immune surveillance.
• Total HIV-1 DNA in PBMCs serves as a reliable measure of the viral reservoir.

Purpose of the Study:

• To highlight the critical window of opportunity during AHI for therapeutic intervention.
• To emphasize the role of early treatment in modulating viral reservoir dynamics and immune responses.
• To identify AHI patients as ideal candidates for functional cure strategies.

Main Methods:

• Review of current understanding of AHI pathogenesis and viral persistence.
• Discussion of the impact of early antiretroviral therapy (ART) initiation.
• Analysis of total HIV-1 DNA measurement in PBMCs as a reservoir marker.

Main Results:

• Early ART initiation during AHI can alter reservoir expansion and reduce long-lived reservoirs.
• Treatment during AHI may lead to post-treatment controllers, offering insights into viral control mechanisms.
• AHI is associated with high viral replication and increased HIV transmission risk.

Conclusions:

• Early detection and treatment of AHI are crucial for controlling the epidemic and reducing transmission.
• Treating AHI offers a unique opportunity to test strategies for functional HIV cure.
• Understanding AHI dynamics is key to developing long-term HIV control strategies.