ObjectivesTo investigate the impact of early combined antiretroviral therapy (cART) on inflammation biomarkers and immune activation during acute and early chronic HIV-1 infection.MethodsWe included 12 acute (AHI), 11 early chronic (EcHI), and 18 late chronic HIV-1-infected (LcHI) individuals who were treated with cART and 18 HIV-1-uninfected (HIV-neg) individuals. Plasmatic levels of inflammation biomarkers, CD8+CD38+HLA-DR+ T cell frequencies, CD4 T cell counts, CD4/CD8 ratio, total HIV-1 DNA and plasmatic viral load were evaluated. Mann–Whitney test, Pearson and Spearman correlation, and linear regression models were used for statistical analyses.ResultsIP-10, IL-18, and sCD163 were significantly elevated at pre-ART in the AHI and EcHI groups, showing a significant reduction after 6 months of cART in the AHI group, achieving similar levels to the HIV-neg group. For the EcHI group, the IP-10 and sCD163 levels were also significantly reduced on M6-ART; however, IP-10 levels remained higher than in the HIV-neg group, and no significant reduction of IL-18 levels was observed. The CD8+ T cell activation levels were elevated in the AHI and EcHI groups at pre-ART and showed a significant reduction on M6-ART, but they were similar to levels seen for HIV-neg only after 12 months of cART. At pre-ART, IP-10 levels but not IL-18 levels were positively correlated with HIV-1 viral load in the AHI group.ConclusionsEarly initiation of cART in HIV infection can reduce systemic inflammation, but the earlier normalization of the inflammation markers was only observed when cART was initiated in the acute phase of infection. A slower dynamic of reduction was observed for CD8+ T cell activation.

中文翻译：

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在急性期开始 cART 6 个月后炎症和 T 细胞活化减少，但在早期慢性 HIV-1 感染中没有

目的探讨早期联合抗逆转录病毒疗法 (cART) 对急性和早期慢性 HIV-1 感染期间炎症生物标志物和免疫激活的影响。方法我们包括 12 名急性 (AHI)、11 名早期慢性 (EcHI) 和 18 名晚期慢性 HIV-1接受 cART 治疗的感染 (LcHI) 个体和 18 名 HIV-1 未感染 (HIV-neg) 个体。评估了炎症生物标志物的血浆水平、CD8+CD38+HLA-DR+T 细胞频率、CD4 T 细胞计数、CD4/CD8 比率、总 HIV-1 DNA 和血浆病毒载量。Mann-Whitney 检验、Pearson 和 Spearman 相关以及线性回归模型用于统计分析。 结果 AHI 和 EcHI 组的 ART 前 IP-10、IL-18 和 sCD163 显着升高，6 后显着降低在 AHI 组的几个月的 cART，达到与 HIV-neg 组相似的水平。对于 EcHI 组，M6-ART 组的 IP-10 和 sCD163 水平也显着降低；然而，IP-10 水平仍然高于 HIV-neg 组，并且没有观察到 IL-18 水平显着降低。ART 前 AHI 和 EcHI 组的 CD8+ T 细胞活化水平升高，M6-ART 显着降低，但它们与仅在 cART 12 个月后观察到的 HIV-neg 水平相似。在 ART 前，IP-10 水平而非 IL-18 水平与 AHI 组中的 HIV-1 病毒载量呈正相关。结论在 HIV 感染中早期启动 cART 可以减少全身炎症，但炎症标志物的较早正常化是仅在感染的急性期启动 cART 时观察到。