  
Treatment during primary HIV infection restricts viral evolution
Last Updated: 2001-04-10 12:00:53 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - HIV DNA replication and mutation is restricted in subjects who initiate treatment with highly active antiretroviral therapy (HAART) during primary infection, according to results of a Swedish study.
Dr. Anders Sonnerborg of the Karolinska Institutet in Stockholm and associates studied viral evolution and HIV-1 DNA dynamics in 16 subjects with primary HIV-1 infection, 9 of whom initiated HAART within a median of 11 days after onset of symptoms.
The investigators conducted extensive sequential cloning and sequence analysis of the V3 region in three HAART-treated subjects and one untreated subject. "In the treated subjects a continuous decline in the proviral load was found, corresponding to a half-life of about 6 months," Dr. Sonnerborg's group reports in the March 20th issue of AIDS Research and Human Retroviruses. In all four subjects, high intrasubject sequence similarity was observed in the founder virus populations.
However, the three treated subjects exhibited a limited increase in viral divergence and diversity over time. In two of three treated subjects, limited sequence evolution of no more than three mutations was observed by up to 6 months.
The researchers also observed that a continuous decline in viral slope correlated with the decay rate of human memory T lymphocytes.
Dr. Sonnerborg's group suggests that early treatment may result in a smaller pool of infected CD4+ T cells and may prevent HIV-1 from entering compartments resistant to drug penetration.
AIDS Res Hum Retroviruses 2001;17:409-416.
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