Early initiation of antiretroviral therapy (ART) in acute HIV infection (AHI) is effective at limiting seeding of the HIV viral reservoir, but little is known about how the resultant decreased antigen load affects long-term Ab development after ART. We report here that Env-specific plasma antibody (Ab) levels and Ab-dependent cellular cytotoxicity (ADCC) increased during the first 24 weeks of ART and correlated with Ab levels persisting after 48 weeks of ART. Participants treated in AHI stage 1 had lower Env-specific Ab levels and ADCC activity on ART than did those treated later. Importantly, participants who initiated ART after peak viremia in AHI developed elevated cross-clade ADCC responses that were detectable 1 year after ART initiation, even though clinically undetectable viremia was reached by 24 weeks. These data suggest that there is more germinal center (GC) activity in the later stages of AHI and that Ab development continues in the absence of detectable viremia during the first year of suppressive ART. The development of therapeutic interventions that can enhance earlier development of GCs in AHI and Abs after ART initiation could provide important protection against the viral reservoir that is seeded in individuals treated early in the disease.

中文翻译：

---

在急性 HIV 感染中开始抗逆转录病毒治疗后长达 1 年的抗 HIV 抗体产生

在急性 HIV 感染 (AHI) 中早期开始抗逆转录病毒治疗 (ART) 可有效限制 HIV 病毒库的播种，但对于由此产生的抗原载量降低如何影响 ART 后的长期抗体发育，我们知之甚少。我们在此报告 Env 特异性血浆抗体 (Ab) 水平和 Ab 依赖性细胞毒性 (ADCC) 在 ART 的前 24 周期间增加，并且与 ART 48 周后持续存在的 Ab 水平相关。在 AHI 第 1 阶段接受治疗的参与者的 Env 特异性抗体水平和对 ART 的 ADCC 活性低于后来接受治疗的参与者。重要的是，在 AHI 病毒血症高峰后开始 ART 的参与者出现了升高的跨进化枝 ADCC 反应，这些反应在 ART 开始后 1 年可检测到，尽管在 24 周时达到了临床上无法检测到的病毒血症。这些数据表明，在 AHI 的后期阶段有更多的生发中心 (GC) 活动，并且在抑制性 ART 的第一年中，在没有可检测到的病毒血症的情况下，抗体的发展仍在继续。治疗干预的发展可以促进 ART 开始后 AHI 和 Abs 中 GC 的早期发展，可以为在疾病早期治疗的个体中播种的病毒库提供重要保护。