Kinetics of plasma cytokines and chemokines during primary HIV-1 infection and after analytical treatment interruption

Background There are strong theoretical arguments for initiating antiretroviral therapy ( ART) during primary HIV-1 infection ( PHI) to preserve HIV-1-specific T-cell responses and to decrease immune activation. Methods We assessed the degree of immune activation during PHI and after analytical treatment interruption (ATI) in plasma samples from 22 subjects by measuring 13 cytokines/chemokines with the Luminex system. Subjects initiated quadruple ART at PHI ( the QUEST cohort) and were classified as responders or nonresponders according to their HIV-1 viral load (VL) 6 months post-ATI. Results During PHI, nonresponders had higher levels of IIIV-1 RNA, interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-10 and eotaxin than responders ( P <= 0.05). A positive correlation was found between VL and IFN-alpha, TNF-alpha, IL-1 beta, macrophage inflammatory protein (MIP)-1 alpha and MIP-1 beta, respectively. Post ATI, responders had higher levels of IFN-gamma, MIP-1 beta and monocyte chemotactic protein (MCP)-1 than nonresponders, while nonresponders had higher levels of HIV-1 RNA, IL-15 and eotaxin. Cytokine/chemokine levels were higher during PHI than post-ATI. Conclusions High levels of immune activation during PHI are associated with a worse virological outcome post-ATI. In contrast, VL post-ATI is negatively correlated with IFN-gamma and chemokines. Therefore, the degree of immune activation during PHI is associated with both the VL at PHI and the viral set-point post-ART.