We report the case of a patient with a very profound CD4 T cell lymphopenia <20 cells/mm3 in the context of a primary HIV-1 infection, associated with both delayed HIV-specific antibody and CD8 T cell responses. A long-term immune reconstitution was observed after immediate initiation of antiretroviral therapy.
Get full access to this article
View all access options for this article.
References
1.
GhosnJ, DeveauC, ChaixM-L, et al.: Despite being highly diverse, immunovirological status strongly correlates with clinical symptoms during primary HIV-1 infection: A cross-sectional study based on 674 patients enrolled in the ANRS CO 06 PRIMO cohort. J Antimicrob Chemother, 2010; 65:741–748.
2.
SocíasME, SuedO, LauferN, 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.
3.
FerrazRV, CarvalhoAC, AraújoF, KochC, AbreuC, SarmentoA: Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART. BMC Infect Dis, 2016; 16:619.
4.
de SouzaMS, PinyakornS, AkapiratS, et al.: Initiation of antiretroviral therapy during acute HIV-1 infection leads to a high rate of nonreactive HIV serology. Clin Infect Dis, 2016; 63:555–561.
5.
RosenbergES, AltfeldM, PoonSH, et al.: Immune control of HIV-1 after early treatment of acute infection. Nature, 2000; 407:523–526.
6.
Zolla-PaznerS, GornyMK, HonnenWJ, PinterA: Reinterpretation of human immunodeficiency virus western blot patterns. N Engl J Med, 1989; 320:1280–1281.
7.
LangeJM, PaulDA, HuismanHG, et al.: Persistent HIV antigenaemia and decline of HIV core antibodies associated with transition to AIDS. Br Med J Clin Res Ed, 1986; 293:1459–1462.
8.
UngprasertP, PermpalungN, SrivaliN, BischofEF, EdmondsLC: Pneumocystis pneumonia during primary HIV infection: A case report and review of the literature. J Infect Chemother, 2013; 19:990–991.
9.
FrangeP, ChaixM-L, RaymondS, et al.Low frequency of CXCR4-using viruses in patients at the time of primary non-subtype-B HIV-1 infection. J Clin Microbiol, 2010; 48:3487–3491.
10.
SchrammB, PennML, SpeckRF, et al.: Viral entry through CXCR4 is a pathogenic factor and therapeutic target in human immunodeficiency virus type 1 disease. J Virol, 2000; 74:184–192.
11.
StreeckH, LuR, BeckwithN, et al.: Emergence of individual HIV-specific CD8 T cell responses during primary HIV-1 infection can determine long-term disease outcome. J Virol, 2014; 88:12793–12801.
12.
GuihotA, TubianaR, BretonG, et al.: Immune and virological benefits of 10 years of permanent viral control with antiretroviral therapy. AIDS, 2010; 614–617.
13.
AutranB, CarcelainG, LiTS, et al.: Positive effects of combined antiretroviral therapy on CD4+ T cell homeostasis and function in advanced HIV disease. Science, 1997; 277:112–116.
14.
BouscaratF, Levacher-ClergeotM, DazzaMC, et al.: Correlation of CD8 lymphocyte activation with cellular viremia and plasma HIV RNA levels in asymptomatic patients infected by human immunodeficiency virus type 1. AIDS Res Hum Retroviruses, 1996; 12:17–24.
15.
MontagnierL, BrennerC, ChamaretS, et al.: Human immunodeficiency virus infection and AIDS in a person with negative serology. J Infect Dis, 1997; 175:955–959.
16.
PadiglioneA, AleksicE, FrenchM, et al.: Extremely prolonged HIV seroconversion associated with an MHC haplotype carrying disease susceptibility genes for antibody deficiency disorders. Clin Immunol Orlando Fla, 2010; 137:199–208.
17.
Balugo-LópezV, Hernández García de la BarreraE, SastreJ: Resolution of common variable immunodeficiency after HIV infection. J Investig Allergol Clin Immunol, 2016; 26:333–334.
18.
BlancA, BonnetF, Brun-VezinetF, et al.: Management of people living with HIV. In: Therapeutic Management. CNS, ANRS-2018. 2018; 57.