Long-term antiretroviral therapy initiated during primary HIV-1 infection is key to achieving both low HIV reservoirs and normal T cell counts

versus 31% CD4+; CD4+/CD8+ 1.31 versus 0.77; all P , 0.0001). Finally, OVIR status was obtained in 19/35 (54%) and 7/272 (3%) patients in the PHI and CHI groups (P , 0.0001), respectively. In a logistic regression analysis, cART initiation during PHI (OR ¼ 16, 95% CI ¼ 3.5 –72.3) and HIV DNA level ,3.3 log10 before treatment (OR ¼ 4.8, 95% CI ¼ 1.2 –19.3) were independently predictive of OVIR status. Conclusions: Initiating cART during PHI represents a major opportunity to reduce HIV reservoirs and achieve optimal immune reconstitution.