Analysis of the immunologic events during the primary immune response to HIV infection
Following resolution of the clinical symptoms and of the initial burst of viremia associated with primary HIV infection, most individuals remain asymptomatic for several years; however, HIV replication is continuous in the lymphoid organs and HIV disease is active and progressive even during the clinically latent period of infection. The inevitable outcome of these pathogenic events that have initiated at the time of primary infection is the progression to AIDS. Of note, the rate of HIV disease progression may vary significantly among different individuals, and the mechanisms responsible for rapid versus slow progression of HIV disease remain to be defined. Oligoclonal perturbations of CD8+ T cell subsets bearing T cell receptors (TCR) with unique variable domains (V) of the beta chain (b) may be observed during primary HIV infection. The expanded CD8+ Vb populations possess HIV-specific cytolytic activity and are an important component of the primary immune response to HIV infection. The analysis of the Vb repertoire in patients experiencing primary HIV infection suggests that qualitative differences in the primary immune response (i.e. patterns of Vb expansions) may significantly influence the rate of HIV disease progression.