Acute HIV Infection: The Impact of Early Antiretroviral Therapy

Authors

  • Ana Oliveira Interna de Formação Específica em Medicina Interna, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0002-9619-262X
  • Tânia Ferreira Interna de Formação Específica em Medicina Interna, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0003-2808-5918
  • Margarida França Assistente Hospitalar Graduada em Medicina Interna, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0001-6299-3237
  • Carlos Vasconcelos Chefe de Serviço em Medicina Interna - Unidade de Imunologia Clínica, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal https://orcid.org/0000-0002-8073-5028

DOI:

https://doi.org/10.24950/O/194/20/4/2020

Keywords:

Anti-Retroviral Agents/therapeutic use, HIV Infections/ drug therapy

Abstract

Human immunodeficiency virus (HIV) primary infection appears to create an unique opportunity to preserve the patient immunologic state, with impact on survival and disease transmition. Based on that, antiretroviral therapy is this phase of the infection, is recommended by the most important international guidelines. Authors present a retrospective study about HIV primary infection with regard to epidemiological, clinical and immunologic aspects, in patients followed at Centro Hospitalar Universitário do Porto Clinical Immunology Unit consultation. Early antiretroviral therapy institution in HIV primary infection has been used in selected patients of this clinic, before official recommendation. Our results are concordant with other studies that have been showing benefits from early treatment, in what concerns to immunological recovery and preservation.

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References

Ambrosioni J, Nicolas D, Sued O, Agüero F, Manzardo C, Miro JM. Update on antiretroviral treatment during primary HIV infection. Expert Rev Anti Infect Ther. 2014 ;12:793-807. doi: 10.1586/14787210.2014.913981.

Yerly S, Hirschel B. Diagnosing acute HIV infection. Expert Rev Anti Infect Ther. 2012;10:31-41.

Nishimura Y, Martin MA. The acute HIV infection: implications for intervention, prevention and development of an effective AIDS vaccine. Curr Opin Virol. 2011;1:204-10. doi: 10.1016/j.coviro.2011.05.007.

Self WH. Acute HIV Infection: Diagnosis and Management in the Emergency Department. Emerg Med Clin N Am. 2010; 28: 381-92.

Guidelines for the Use of Antoretroviral Agents in Adults and Adolescents with HIV – Considerations for Antiretroviral Use in Special Patient Populations: Acute and Recent (Early) HIV Infection. 2018. [consultado Maio 2019] Disponível em: https://aidsinfo.nih.gov/guidelines/brief-html/1/adult-and-adolescent-arv/20/acute-and-recent--early--hiv-infection

European AIDS Clinical Society. Linhas Orientadoras. Versão 9.0. Outubro 2017. [consultado Maio 2019] Disponível em: https://www.eacsociety.org/

Henn A, Flateau C, Gallien S. Primary HIV infection: clinical presentation, testing, and treatment. Curr Infect Dis Resp.2017; 19:37. doi: 10.1007/s11908-017-0588-3.

Robb ML, Eller LA, Kibuuka H, Rono K, Maganga L, Nitayaphan S, et al. Prospective Study of Acute HIV-1 Infection in Adults in East Africa and Thailand. N Engl J Med. 2016;374:2120-30. doi: 10.1056/NEJMoa1508952.

MacNeal RJ, Dinulos JG. Acute Retroviral Syndrome. Dermatol Clin. 2006; 24:431-8.

Braun DL, Kouyos RD, Balmer B, Grube C, Weber R, Günthard HF. Frequency and Spectrum of Unexpected Clinical Manifestations of Primary HIV-1 Infection. Clin Infect Dis. 2015;61:1013-21. doi: 10.1093/cid/civ398.

Crowell TA, Colby DJ, Pinyakorn S, Fletcher JLK, Kroon E, Schuetz A, et al. Acute Retroviral Syndrome Is Associated With High Viral Burden, CD4 Depletion, and Immune Activation in Systemic and Tissue Compartments. Clin Infect Dis. 2018;66:1540-9. doi: 10.1093/cid/cix1063.

Richey LE, Halperin J. Acute Human Immunodeficiency Virus Infection. Am J Med Sci. 2013;345:136-42.

Sáez-Cirión A, Bacchus C, Hocqueloux L, Avettand-Fenoel V, Girault I, Lecuroux C, et al. Post-treatment HIV-1 controllers with a long-term virological remission after the interruption of early initiated antiretroviral therapy ANRS VISCONTI Study. PLoS Pathog. 2013;9:e1003211. doi: 10.1371/journal.ppat.1003211.

Rouzioux C, Hocqueloux L, Sáez-Cirión A. Posttreatment controllers: what do they tell us? Curr Opin HIV AIDS. 2015; 10:29-34.

Lee EY, Yue FY, Jones RB, Lo C, Sheth P, Hyrcza MD, et al. The impact of CCL3L1 copy number in an HIV-1-infected white population. AIDS. 2010;24:1589-91. doi: 10.1097/QAD.0b013e3283398294.

Lodi S, Meyer L, Kelleher AD, Rosinska M, Ghosn J, Sannes M, et al. Immunovirologic control 24 months after interruption of antiretroviral therapy initiated close to HIV seroconversion. Arch Intern Med. 2012;172:1252-5. doi: 10.1001/archinternmed.2012.2719.

Fidler S, Olson AD, Bucher HC, Fox J, Thornhill J, Morrison C, et al. Virological Blips and Predictors of Post Treatment Viral Control After Stopping ART Started in Primary HIV Infection. J Acquir Immune Defic Syndr. 2017;74:126-33. doi: 10.1097/QAI.0000000000001220.

Hoenigl M, Braun DL, Kouyos R, Günthard HF, Little SJ. Evaluation of the Predictive Potential of the Short Acute Retroviral Syndrome Severity Score for HIV-1 Disease Progression in Individuals With Acute HIV Infection. J Acquir Immune Defic Syndr. 2017;74:e114-e117. doi: 10.1097/QAI.0000000000001263.

Jain V, Hartogensis W, Bacchetti P, Hunt PW, Hatano H, Sinclair E, et al. Antiretroviral therapy initiated within 6 months of HIV infection is associated with lower T-cell activation and smaller HIV reservoir size. J Infect Dis. 2013;208:1202-11. doi: 10.1093/infdis/jit311.

Socías ME, Sued O, Laufer N, Lázaro ME, Mingrone H, Pryluka D, et al. Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters. J Int AIDS Soc. 2011;14:40. doi: 10.1186/1758-2652-14-40.

Published

2021-09-23

How to Cite

1.
Oliveira A, Ferreira T, França M, Vasconcelos C. Acute HIV Infection: The Impact of Early Antiretroviral Therapy. RPMI [Internet]. 2021 Sep. 23 [cited 2024 Nov. 21];27(4):314-9. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/101

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