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Evolution of Antibody Responses during Acute Infection
Georgia Tomaras
Human Vaccine Inst, Duke Univ Med Ctr, Durham, NC, US
A window of opportunity for immune responses to extinguish
HIV-1 exists from the moment of transmission through establishment of the
latent pool of HIV-1-infected cells. A critical time to study the initial
immune responses to the transmitted/founder virus is the eclipse phase of HIV-1
infection (time from transmission to the first appearance of plasma virus). To
probe B cell responses immediately following HIV-1 transmission, we determined
envelope-specific antibody responses to autologous and consensus Env in
subjects for whom frequent plasma samples were available immediately before,
during, and after HIV-1 plasma viral load ramp-up in acute infection, and
modeled antibody effect on the kinetics of plasma viremia. The first detectable
B cell response was in the form of antibody–virion immune complexes 8 days
after first plasma virus detection (100 copies/mL), whereas the first free
plasma anti-HIV-1 antibody was to gp41 and appeared 13 days after the
appearance of plasma virus. In contrast, envelope gp120-specific antibodies
were delayed an additional 14 days. Thus, the host–pathogen interactions
occurring during and immediately after transmission result in a delay in
recognition of gp120 by host B cells until after the latent pool of infected
cells is likely established. We also found rheumatoid factor in approximately
30% of subjects, thus likely indicating polyclonal B cell activation of CD5+
B cells, which produce rheumatoid factor auto-antibodies. Also of interest is
the heterogeneity in the pattern of immunoglobulin (Ig) class-switching
following HIV-1 transmission. Mathematical
modeling of the earliest viral dynamics with the initial anti-gp41
IgG and IgM antibody responses demonstrated that the first IgM and IgG
antibodies induced by transmitted HIV-1 had little effect on reducing acute
phase viremia at the timing and magnitude that they occur in natural infection.
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