Treatment of primary HIV-1 infection with cyclosporin A coupled with highly active antiretroviral therapy

G. Paolo Rizzardi, Alexandre Harari, Brunella Capiluppi, Giuseppe Tambussi, Kim Ellefsen, Donatella Ciuffreda, Patrick Champagne, Pierre Alexandre Bart, Jean Philippe Chave, Adriano Lazzarin, Giuseppe Pantaleo

Research output: Contribution to journalArticle

Abstract

Primary HIV-1 infection causes extensive immune activation, during which CD4+ T cell activation supports massive HIV-1 production. We tested the safety and the immune-modulating effects of combining cyclosporin A (CsA) treatment with highly active antiretroviral therapy (HAART) during primary HIV-1 infection. Nine adults with primary HIV-1 infection were treated with CsA along with HAART. At week 8, all patients discontinued CsA but maintained HAART. Viral replication was suppressed to a comparable extent in the CsA + HAART cohort and in 29 control patients whose primary infection was treated with HAART alone. CsA restored normal CD4+ T cell levels, both in terms of percentage and absolute numbers. The increase in CD4+ T cells was apparent within a week and persisted throughout the study period. CsA was not detrimental to vires-specific CD8+ or CD4+ T cell responses. At week 48, the proportion of IFN-γ-secreting CD4+ and CD4+CCR7- T cells was significantly higher in the CsA + HAART cohort than in the HAART-alone cohort. In conclusion, rapid shutdown of T cell activation in the early phases of primary HIV-1 infection can have long-term beneficial effects and establish a more favorable immunologic set-point. Appropriate, immune-based therapeutic interventions may represent a valuable complement to HAART for treating HIV infection.

Original languageEnglish
Pages (from-to)681-688
Number of pages8
JournalJournal of Clinical Investigation
Volume109
Issue number5
DOIs
Publication statusPublished - 2002

ASJC Scopus subject areas

  • Medicine(all)

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    Paolo Rizzardi, G., Harari, A., Capiluppi, B., Tambussi, G., Ellefsen, K., Ciuffreda, D., Champagne, P., Bart, P. A., Chave, J. P., Lazzarin, A., & Pantaleo, G. (2002). Treatment of primary HIV-1 infection with cyclosporin A coupled with highly active antiretroviral therapy. Journal of Clinical Investigation, 109(5), 681-688. https://doi.org/10.1172/JCI200214522