CTL RESPONSE IN ACUTE HIV INFECTION

急性HIV-1感染的特点是高水平的病毒血症， 随后下降到准设定点。在最早的阶段 大多数人会患上传染性单核细胞病毒- 就像发烧、皮疹、咽炎的各种组合综合征， 口腔和生殖器溃疡。从历史上看，这类案件中的大多数 没有被诊断，主要是因为 症状和缺乏可靠诊断的现成检测方法 急性感染。病毒载量测量技术的出现 促进了急性艾滋病毒感染的早期诊断， 高效抗逆转录病毒疗法的可获得性为 在早期阶段进行治疗干预的机会 感染。对急性感染者的研究表明， 病毒血症的最初下降与出现 CTL，但这些研究在数量上有限，以至于广度 CTL反应在早期感染中的特异性尚不完全 明白了。此外，早期抗病毒作用的研究 目前还没有对免疫反应的个体发生进行治疗。 宿主实验室最近的研究表明，早期 抗逆转录病毒干预导致HIV-1特异性恢复 CD4对p24和gp160的增殖反应。因为特定于病毒 CD_4细胞在维持慢性粒细胞白血病CTL反应中的作用 病毒感染，关键是不仅要确定CTL 在急性感染期间对艾滋病毒的反应，也是早期的影响 对这种反应的治疗。探讨急性胰腺炎的免疫发病机制 艾滋病毒感染，马萨诸塞州综合医院艾滋病研究中心 医院确认了9名急性艾滋病毒携带者 感染。本提案中要检验的假设是 急性HIV感染期间的早期抗病毒治疗将与 保持和改进了对艾滋病毒的CTL反应。是否可以使用 这群急性感染的患者提供了独特的机会 目的：研究HIV原发感染的免疫学特征。为了测试这一点 假设将进行一系列实验以：1)表征 初发感染中CTL应答的大小和广度 并将这些结果与CTL进行比较 未接受HAART治疗的急性感染患者的反应； 2)定义CTL反应与发展的关系 CD4Help与病毒载量的降低；3)表位的表征 克隆法检测HIV原发感染中CTL反应的特异性 特异性刺激的CD8细胞；4)检测CTL能力 在急性感染期间引起的抑制病毒复制的反应。 这些研究将提供有关免疫的重要信息。 在急性HIV期间有助于控制HIV复制的机制 感染。

Acute HIV-1 infection is characterized by high level viremia, which subsequently declines to a quasi set-point. During the earliest stages of infection the majority of persons will develop an infectious mono- like syndrome with variable combinations of fever, rash, pharyngitis, oral and genital ulcers. Historically the majority of such cases have not been diagnosed, largely because of the non-specific nature of the symptoms and the lack of readily available assays to reliably diagnose the acute infection. The advent of viral load measurements has faciliated the early diagnosis of acute HIV infection, and the availability of highly active antiretroviral therapy has provided the opportunity to intervene therapeutically at the early stage of infection. Studies of acutely infected persons have indicated that the initial drop in viremia is temporally associated with the appearance of CTL, but these studies have been limited in number such that the breadth specificity of the CTL response in early infection is imcompletely understood. Furthermore, studies of the effects of early antiviral therapy on the ontogeny of the immune response have not been performed. Recent studies in the host laboratory have shown that early antiretroviral intervention results in the restoration of HIV-1-specific CD4 proliferative responses to both p24 and gp160. Since virus-specific CD4 cells are essential for maintenance of CTL responses in chronic viral infections, it is essential to determine not only the CTL response to HIV during acute infection, but also the effects of early therapy on this response. To address the immunopathogenesis of acute HIV infection, the AIDS Research Center at Massachusetts General Hospital has identified a cohort of 9 individuals with acute HIV infection. The hypothesis to be tested in the present proposal is that early antiviral therapy during acute HIV infection will be associated with preserved and improved CTL responses to HIV. The availability of this cohort of acutely infected patients affords the unique opportunity to study the immunology of primary HIV infection. To test this hypothesis a series of experiments will be performed to: 1) Characterize the magnitude and breadth of the CTL response in primary infection in acutely infected patients and compare these results with the CTL responses in acutely infected patients who were not treated with HAART; 2) Define the relationship of the CTL response with the development of CD4 help and the diminution of viral load; 3) Characterize the epitope specificity of CTL responses in primary HIV infection by cloning specifically stimulated CD8 cells; 4) Examine the ability of CTL responses elicited during acute infection to inhibit viral replication. These studies will provide important information regarding the immune mechanisms contributing to control of HIV replication during acute HIV infection.