Herout Sandra, Mandorfer Mattias, Breitenecker Florian, Reiberger Thomas, Grabmeier-Pfistershammer Katharina, Rieger Armin, Aichelburg Maximilian C
Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria.
PLoS One. 2016 Apr 11;11(4):e0152910. doi: 10.1371/journal.pone.0152910. eCollection 2016.
It is unclear whether antiretroviral therapy (ART) should be initiated during acute HIV infection. Most recent data provides evidence of benefits of early ART.
We retrospectively compared the clinical and immunological course of individuals with acute HIV infection, who received ART within 3 months (group A) or not (group B) after diagnosis.
Among the 84 individuals with acute HIV infection, 57 (68%) received ART within 3 months (A) whereas 27 (32%) did not receive ART within 3 months (B), respectively. Clinical progression to CDC stadium B or C within 5 years after the diagnosis of HIV was less common in (A) when compared to (B) (P = 0.002). After twelve months, both the mean increase in CD4+ T cell count and the mean decrease in viral load was more pronounced in (A), when compared to (B) (225 vs. 87 cells/μl; P = 0.002 and -4.19 vs. -1.14 log10 copies/mL; P<0.001). Twenty-four months after diagnosis the mean increase from baseline of CD4+ T cells was still higher in group A compared to group B (251 vs. 67 cells/μl, P = 0.004).
Initiation of ART during acute HIV infection is associated with a lower probability of clinical progression to more advanced CDC stages and significant immunological benefits.
在急性HIV感染期间是否应开始抗逆转录病毒治疗（ART）尚不清楚。最新数据提供了早期ART获益的证据。
我们回顾性比较了急性HIV感染患者的临床和免疫病程，这些患者在诊断后3个月内接受ART（A组）或未接受ART（B组）。
在84例急性HIV感染患者中，57例（68%）在3个月内接受了ART（A组），而27例（32%）在3个月内未接受ART（B组）。与（B组）相比，（A组）在HIV诊断后5年内临床进展至疾病控制中心（CDC）B期或C期的情况较少见（P = 0.002）。12个月后，与（B组）相比，（A组）CD4 + T细胞计数的平均增加和病毒载量的平均下降更为明显（分别为225对87个细胞/μl；P = 0.002以及-4.19对-1.14 log10拷贝/mL；P<0.001）。诊断24个月后，A组CD4 + T细胞相对于基线的平均增加仍高于B组（251对67个细胞/μl，P = 0.004）。
在急性HIV感染期间开始ART与临床进展至更晚期CDC阶段的可能性较低以及显著的免疫获益相关。
