The cells that produce antibodies to HIV and other pathogens — B cells — are more activated, unstable and unresponsive among untreated patients with HIV compared with normal B cells in otherwise healthy patients, according to researchers.

Anthony S. Fauci, MD, chief of the National Institute of Allergy and Infectious Disease’s Laboratory of Immunoregulation and colleagues used advanced tools to probe B-cell responses to HIV and other pathogens to better understand memory B cell response among patients with HIV.

The earlier a person started treatment for HIV, the greater their capacity to maintain pretreatment levels of B-cell response to the virus, the researchers reported in the Journal of Clinical Investigation. Furthermore, those with mostly normal resting memory B cells were more likely to have low viral load and low immune activation.

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“Given our previous findings that both the frequency and functionality of resting memory B cells are better preserved in early-treated individuals, our current findings provide an additional potential immunological benefit in facilitating the normalization of HIV-specific B cell responses by anti-HIV therapy,” the researchers wrote.

The researchers also compared B-cell responses to HIV with responses to other pathogens, including tetanus and influenza. The B-cell response tended to be relatively normal to tetanus, but not for influenza. This might be due to the fact that participants were likely immunized against tetanus before acquiring HIV infection and maintained a normal B-cell response years later, and had likely been exposed to different strains of influenza after acquiring influenza.

“[T]his study provides a pathophysiologic mechanism to explain, at least in part, the poor HIV-specific antibody response, […] and provides an additional scientific rationale for the early treatment of HIV-infected individuals for the purpose of reconstituting the HIV-specific antibody response within the normal resting memory B cell subset,” the researchers wrote.


  1. Kardava L. J Clin Invest. 2014; 124:3252–3262.