The acute HIV infection: implications for intervention, prevention and development of an effective AIDS vaccine

Effective preventive measures against HIV must function near the time of virus transmission to prevent the establishment of a chronic infection. Low-dose SIV/SHIV infections by multiple routes lead to remarkably rapid systemic dissemination of virus and large numbers of infected cells during the initial weeks of the acute infection. Here we describe the narrow time-frame during which potent post-exposure interventions such as anti-retroviral therapy or the administration of high-titered neutralizing antibodies can block the establishment of the in vivo infection. This short window of opportunity is applicable to HIV infections and represents a formidable challenge for developing effective chemoprophylaxis and vaccine approaches.

► Kinetics of SIV/SHIV infection are dependent on dose and transmission route.
► Exponential virus replication rates are independent of transmission routes.
► During the acute infection, 30–90% of CD4 T cells become productively infected.
► The time frame for blocking SIV/SHIV acquisition is 6–24 h post exposure.
► This narrow window of opportunity must be considered in HIV vaccine development.