We studied the effect of entry inhibitors on 58 virus isolates derived during acute and chronic infection to validate these inhibitors in vitro and to probe whether viruses at early and chronic disease stages exhibit general differences in the interaction with entry receptors. We included members of all types of inhibitors currently identified: (i) agents that block gp120 binding to CD4 (CD4-IgG 2 and monoclonal antibody [MAb] IgG 1 b12), (ii) compounds that block the interaction with CCR5 (the chemokine RANTES/CCL5, the smallmolecule inhibitor AD101, and the anti-CCR5 antibody PRO 140), (iii) the fusion inhibitor enfuvirtide (T-20), and (iv) neutralizing antibodies directed against gp120 (MAb 2G12) and gp41 (MAbs 2F5 and 4E10). No differences between viruses from acute and chronic infections in the susceptibility to inhibitors targeting the CD4 binding site, CCR5, or fusion or to MAb 2G12 were apparent, rendering treatment with entry inhibitors feasible across disease stages. The notable exceptions were antibodies 2F5 and 4E10, which were more potent in inhibiting viruses from acute infection (P ؍ 0.0088 and 0.0005, respectively), although epitopes of these MAbs were equally well preserved in both groups. Activities of these MAbs correlated significantly with each other, suggesting that common features of the viral envelope modulate their potencies.Therapy of human immunodeficiency virus type 1 (HIV-1) infection with a combination of antiretrovirals inhibiting the viral enzymes reverse transcriptase and protease can significantly decrease HIV-related morbidity and mortality (49, 62). However, due to the toxicity of these drugs and the emergence of resistant viral variants, alternative treatment strategies are urgently needed (31,33,36). Entry of HIV-1 into target cells requires expression of the receptor CD4 and a fusion coreceptor, most commonly the chemokine receptors CCR5 and CXCR4 (19,66). The entry process proceeds via a cascade of events that provide multiple opportunities for therapeutic intervention, and several agents targeting this process have been developed over recent years. Considerable effort has been put into investigating the interaction of the virus with its entry receptors and the identification of potential antiretrovirals (66). Neutralizing antibodies were among the first agents identified which block viral entry. Direct antiviral activity is attributed to antibodies directed against specific epitopes on the envelope glycoproteins gp120 and gp41, which inhibit viral entry by blocking virion attachment to its receptors or membrane fusion (65). During natural infection the effect of the autologous neutralization response appears to be limited, since the virus rapidly escapes the immune pressure in most individuals (14,15,54,55,67,76,101). Nevertheless, rare potent monoclonal antibodies (MAbs) with broad activity have been isolated from infected individuals. These antibodies define four neutralization-sensitive epitopes within gp120 and gp41; they are characterized by the MAbs IgG 1 b12 (5,...