Acute HIV-1 Infection: Paradigm and Singularity

Acute HIV-1 infection (AHI) is a transient period where the virus causes evident damage to the immune system, including an extensive apoptosis of CD4+ T cells associated with a high level of activation and a major cytokine storm to fight the invading virus. HIV infection establishes persistence by i...

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Main Author: Antoine Chéret
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/3/366
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author Antoine Chéret
author_facet Antoine Chéret
author_sort Antoine Chéret
collection DOAJ
description Acute HIV-1 infection (AHI) is a transient period where the virus causes evident damage to the immune system, including an extensive apoptosis of CD4+ T cells associated with a high level of activation and a major cytokine storm to fight the invading virus. HIV infection establishes persistence by integrating the viral genome into host cell DNA in both replicating and non-replicating forms, effectively hiding from immune surveillance within infected lymphocytes as cellular reservoirs. The measurement of total HIV-1 DNA in peripheral blood mononuclear cells (PBMCs) is a reliable reflection of this reservoir. Initiating treatments during AHI with nucleoside reverse transcriptase inhibitors (NRTIs) and/or integrase strand transfer inhibitors (INSTIs) is essential to alter the dynamics of the global reservoir expansion, and to reduce the establishment of long-lived cellular and tissue reservoirs, while preserving and enhancing specific and non-specific immune responses. Furthermore, some of the patients treated at the AHI stage may become post-treatment controllers and should be informative regarding the mechanism of viral control, so patients treated during AHI are undoubtedly the best candidates to test innovative remission strategies toward a functional cure that could play a pivotal role in long-term HIV control. AHI is characterized by high levels of viral replication, with a significant increase in the risk of HIV transmission. Detecting AHI and initiating early treatment following diagnosis provides a window of opportunity to control the epidemic, particularly in high-risk populations.
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spelling doaj-art-afd989a2a22f4c878228122399df8cd72025-08-20T01:50:07ZengMDPI AGViruses1999-49152025-03-0117336610.3390/v17030366Acute HIV-1 Infection: Paradigm and SingularityAntoine Chéret0Inserm U1016, CNRS UMR 8104, Institut Cochin, Université Paris Descartes, 75014 Paris, FranceAcute HIV-1 infection (AHI) is a transient period where the virus causes evident damage to the immune system, including an extensive apoptosis of CD4+ T cells associated with a high level of activation and a major cytokine storm to fight the invading virus. HIV infection establishes persistence by integrating the viral genome into host cell DNA in both replicating and non-replicating forms, effectively hiding from immune surveillance within infected lymphocytes as cellular reservoirs. The measurement of total HIV-1 DNA in peripheral blood mononuclear cells (PBMCs) is a reliable reflection of this reservoir. Initiating treatments during AHI with nucleoside reverse transcriptase inhibitors (NRTIs) and/or integrase strand transfer inhibitors (INSTIs) is essential to alter the dynamics of the global reservoir expansion, and to reduce the establishment of long-lived cellular and tissue reservoirs, while preserving and enhancing specific and non-specific immune responses. Furthermore, some of the patients treated at the AHI stage may become post-treatment controllers and should be informative regarding the mechanism of viral control, so patients treated during AHI are undoubtedly the best candidates to test innovative remission strategies toward a functional cure that could play a pivotal role in long-term HIV control. AHI is characterized by high levels of viral replication, with a significant increase in the risk of HIV transmission. Detecting AHI and initiating early treatment following diagnosis provides a window of opportunity to control the epidemic, particularly in high-risk populations.https://www.mdpi.com/1999-4915/17/3/366acute HIV infectionHIV-1 DNAreservoirART viral transmission
spellingShingle Antoine Chéret
Acute HIV-1 Infection: Paradigm and Singularity
Viruses
acute HIV infection
HIV-1 DNA
reservoir
ART viral transmission
title Acute HIV-1 Infection: Paradigm and Singularity
title_full Acute HIV-1 Infection: Paradigm and Singularity
title_fullStr Acute HIV-1 Infection: Paradigm and Singularity
title_full_unstemmed Acute HIV-1 Infection: Paradigm and Singularity
title_short Acute HIV-1 Infection: Paradigm and Singularity
title_sort acute hiv 1 infection paradigm and singularity
topic acute HIV infection
HIV-1 DNA
reservoir
ART viral transmission
url https://www.mdpi.com/1999-4915/17/3/366
work_keys_str_mv AT antoinecheret acutehiv1infectionparadigmandsingularity