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Primary Human Immunodeficiency Virus Type 1 Infection: Review of Pathogenesis and Early Treatment Intervention in Humans and Animal Retrovirus Infections

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TLDR
Data from retrovirus-infected animal models treated with antiviral agents suggests that therapy at the time of viral dissemination may be an effective strategy that may modify disease progression, and clinical trials to evaluate this approach are in progress.
Abstract
Primary human immunodeficiency virus type 1 (HIV-1) infection can present clinically as the abrupt onset of a febrile illness resembling acute mononucleosis. The symptoms coincide with high titers of culturable plasma viremia, cell-associated virus, and antigenemia, which rapidly decrease coincident with the emergence of detectable HIV-specific antibody and HIV-specific cytotoxic T lymphocytes. This article reviews the human and animal model data on the virologic and immunologic events that occur during primary HIV-1 and animal retrovirus infections, evaluates the prophylactic treatment experience of retrovirus infections in the animal model, and provides a plausible rationale for treatment intervention of primary HIV-1 infection in humans. Recent work delineating the pathogenesis of primary HIV-1 infection provides insight into the major mechanisms of viral dissemination and host immune response. The results from retrovirus-infected animal models treated with antiviral agents suggests that therapy at the time of viral dissemination may be an effective strategy that may modify disease progression. Clinical trials to evaluate this approach are in progress.

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Acute Human Immunodeficiency Virus Type 1 Infection

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Guidelines for using antiretroviral agents among HIV-infected adults and adolescents: The Panel on Clinical Practices for Treatment of HIV

TL;DR: This report provides pathogenesis-based rationale for therapeutic strategies as well as guidelines for implementing these strategies and recommends that, when possible, the treatment of HIV-infected patients should be directed by a clinician who has extensive experience in the care of these patients.
References
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Journal ArticleDOI

Massive covert infection of helper T lymphocytes and macrophages by HIV during the incubation period of AIDS

TL;DR: An extraordinarily large number of latently infected CD4+ lymphocytes and macrophages are discovered throughout the lymphoid system from early to late stages of infection, and the extracellular association of HIV with follicular dendritic cells is confirmed.
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High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR

TL;DR: Quantitation of HIV-1 in plasma by QC-PCR may be useful in assessing the efficacy of antiretroviral agents, especially in early stage disease when conventional viral markers are often negative.
Journal ArticleDOI

Immunopathogenesis of human immunodeficiency virus infection

TL;DR: In this paper, the role of LFA-1 has been highlighted, and several factors in addition to endogenous viral regulatory proteins have been reported as capable of modulating the state of viral latency and expression in vitro.
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CD8+ lymphocytes can control HIV infection in vitro by suppressing virus replication

TL;DR: A potential approach to therapy in which autologous CD8 lymphocytes could be administered to individuals to inhibit HIV replication and perhaps progression of disease is suggested.
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