Preferential infection and depletion of gut-homing a4b7 CD4 1 T cells in the blood are observed in chronic HIV/SIV infection. The dynamic change in gut-homing a4b7 CD4 1 T cells and their functional subsets during the acute stages of HIV-1 infection are less documented. Therefore, we conducted a cohort study to investigate whether acute HIV-1 infection induced abnormalities in gut-homing a4b7 CD4 1 T cells and their functional subsets. We examined the frequency, absolute number, and functionality of gut-homing a4b7 CD4 1 T cells in 26 acute HIV-1-infected patients compared with 20 healthy individuals. We found that circulating gut-homing a4b7 CD4 1 T cells were preferentially depleted during acute HIV-1 infection and were positively correlated with absolute CD4 1 T-cell count in blood. Notably, Th17 and Th1 cell subsets of gut-homing CD4 1 T cells were also decreased, which resulted in an imbalance of T helper cells (Th1):regulatory T cells (Treg) and Treg:Th17 ratios. Gut-homing Th17 and Th1 cells were also positively correlated with the absolute number of total CD4 1 T cells and gut-homing CD4 1 T cells. The gut-homing Treg:Th17 ratio was inversely correlated with the CD4