A Subset of Extreme Human Immunodeficiency Virus (HIV) Controllers Is Characterized by a Small HIV Blood Reservoir and a Weak T-Cell Activation Level
In: ISSN: 2328-8957, 2017
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International audience ; BACKGROUND:Human immunodeficiency virus controllers (HICs) form a heterogeneous group of patients with regard to formal definitions, immunologic characteristics, and changes over time in viral load.PATIENTS AND METHODS:The HICs with undetectable viral load ([uHICs] ie, for whom a viral load had never been detected with routine assays; n = 52) were compared with 178 HICs with blips during the follow up (bHICs). Clinical characteristics, ultrasensitive HIV-ribonucleic acid (RNA) and HIV-deoxyribonucleic acid (DNA) loads, HIV1-Western blot profiles, and immune parameters were analyzed.RESULTS:Relative to bHICs, uHICs had significantly lower ultrasensitive plasma HIV-RNA loads (P < .0001) and HIV-DNA levels in peripheral blood mononuclear cells (P = .0004), higher CD4+ T-cell count (P = .04) at enrollment, and lower T-cell activation levels. Between diagnosis and inclusion in the cohort, the CD4+ T-cell count had not changed in uHICs but had significantly decreased in bHICs. Twenty-one percent of the uHICs lacked specific anti-HIV immunoglobulin G antibodies, and these individuals also had very low levels of HIV-DNA. Half of the uHICs had a protective human leukocyte antigen (HLA) allele (-B57/58/B27), a weak CD8+ T-cell response, and very small HIV-DNA reservoir.CONCLUSIONS:We suggest that an interesting HIC phenotype combines protective HLA alleles, low level of HIV blood reservoirs, and reduced immune activation. Prospective studies aimed at evaluating the benefit of combined antiretroviral therapy in HICs might take into account the identification of uHICs and bHICs.
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A Subset of Extreme Human Immunodeficiency Virus (HIV) Controllers Is Characterized by a Small HIV Blood Reservoir and a Weak T-Cell Activation Level
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| Autor/in / Beteiligte Person: | Canouï, Etienne ; Lécuroux, Camille ; Avettand-Fenoel, Véronique ; Gousset, Marine ; Rouzioux, Christine ; Saez-Cirion, Asier ; Meyer, Laurence ; Boufassa, Faroudy ; Lambotte, Olivier ; Noël, Nicolas ; Study Group, Anrs Co21 Codex ; Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184) ; Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Bicêtre, Hôpital ; Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre ; Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI) ; Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay ; Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327) ; Université Paris Descartes - Paris 5 (UPD5) ; Laboratoire de Virologie CHU Necker ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Necker - Enfants Malades AP-HP ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) ; HIV, Inflammation et persistance - HIV, Inflammation and Persistence ; Institut Pasteur Paris (IP) ; Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Service de santé publique et d'épidémiologie ; The ANRS Codex cohort is funded by ANRS. |
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| Zeitschrift: | ISSN: 2328-8957, 2017 |
| Veröffentlichung: | HAL CCSD ; Oxford University Press, 2017 |
| Medientyp: | academicJournal |
| DOI: | 10.1093/ofid/ofx064 |
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