Acute HIV infection: the impact of anti‐retroviral treatment on cellular immune responses
The overall value of initiating anti‐retroviral therapy during the acute phase of human immunodeficiency virus type 1 (HIV‐1) infection remains unclear. From a clinical perspective, the lack of data from controlled randomized clinical trials limits understanding of long‐term effects of treatment on the clinical course of HIV infection. Based on available data, the impact of anti‐retroviral therapy during acute infection on the immune response against HIV‐1 is not particularly encouraging. Recent observations on the very early depletion of lymphocyte reservoirs in the gastrointestinal tract may partially explain the limited benefit of anti‐retroviral therapy initiated during the acute phase of HIV‐1 infection. This may also help to explain the dichotomy between early observations demonstrating apparent immunological benefit with early anti‐retroviral treatment that were associated none the less with inability to control viral replication following treatment interruption.