Low human immunodeficiency virus envelope diversity correlates with low in vitro replication capacity and predicts spontaneous control of plasma viremia after treatment interruptions.
Genetic diversity of viral isolates in human immunodeficiency virus (HIV)-infected individuals varies substantially. However, it remains unclear whether HIV-related disease progresses more rapidly in patients harboring virus swarms with low or high diversity and, in the same context, whether high or low diversity is required to induce potent humoral and cellular immune responses. To explore whether viral diversity predicts virologic control, we studied HIV-infected patients who received antiretroviral therapy (ART) for years before undergoing structured treatment interruptions (STI). Viral diversity before initiation of ART and the ability of the patients to contain viremia after STI and final cessation of treatment was evaluated. Seven out of 21 patients contained plasma viremia at low levels after the final treatment cessation. Clonal sequences encompassing the envelope C2V3C3 domain derived from plasma prior to treatment, exhibited significantly lower diversity in these patients compared to those derived from patients with poor control of viremia. Viral diversity pre-ART correlated with the viral replication capacity of rebounding virus isolates during STI. Neutralizing antibody activity against autologous virus was significantly higher in patients who controlled viremia and was associated with lower pretreatment diversity. No such association was found with binding antibodies directed to gp120. In summary, lower pretreatment viral diversity was associated with spontaneous control of viremia, reduced viral replication capacity and higher neutralizing antibody titers, suggesting a link between viral diversity, replication capacity, and neutralizing antibody activity.
University Hospital Zurich, Department of Medicine, Division of Infectious Diseases and Hospital Epidemiology, Rämistrasse 100, CH-8091 Zürich, Switzerland.
Beda
B
Joos
Alexandra
A
Trkola
Marek
M
Fischer
Herbert
H
Kuster
Peter
P
Rusert
Christine
C
Leemann
Jürg
J
Böni
Annette
A
Oxenius
David A
DA
Price
Rodney E
RE
Phillips
Joseph K
JK
Wong
Bernard
B
Hirschel
Rainer
R
Weber
Huldrych F
HF
Günthard
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015686:Gene Products, env / Q000235:genetics*; D006678:HIV / Q000145:classification* / Q000502:physiology; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000821:virology*; D006801:Humans; D010802:Phylogeny; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014766:Viremia / Q000188:drug therapy / Q000821:virology*; D014779:Virus Replication
D019380:Anti-HIV Agents; D015686:Gene Products, env; D015483:HIV Antibodies