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To the Editor: Human immunodeficiency virus 1 (HIV-1) antigen-specific proliferative CD4⁺ T cell responses are typically absent in patients with chronic HIV-1 infection.¹ However, these responses are present in so-called long-term nonprogressors who experience control of viremia even without treatment^1-3 and in patients treated with highly active antiretroviral therapy (HAART) during acute seroconversion who are subsequently able to contain viremia after treatment interruptions.⁴ These findings suggest that the presence of CD4⁺ T cell proliferative responses to HIV-1 may be associated with protection against viral replication.

Methods

We studied 2 patients who were started on HAART during chronic infection and who were unusual in that they had strong and broad HIV-1–specific CD4⁺ T cell responses. Both patients experienced treatment interruptions, which allowed us to examine the relationship between strong proliferative responses to HIV-1 and the control of viremia. Blood was obtained from both patients at various times before and after the discontinuation . . . [Full Text of this Article]

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