title: Post-treatment HIV-1 controllers with a long-term virological remission after the interruption of early initiated antiretroviral therapy ANRS VISCONTI Study.
abstract: Combination antiretroviral therapy (cART) reduces HIV-associated morbidities and mortalities but cannot cure the infection. Given the difficulty of eradicating HIV-1, a functional cure for HIV-infected patients appears to be a more reachable short-term goal. We identified 14 HIV patients (post-treatment controllers [PTCs]) whose viremia remained controlled for several years after the interruption of prolonged cART initiated during the primary infection. Most PTCs lacked the protective HLA B alleles that are overrepresented in spontaneous HIV controllers (HICs); instead, they carried risk-associated HLA alleles that were largely absent among the HICs. Accordingly, the PTCs had poorer CD8+ T cell responses and more severe primary infections than the HICs did. Moreover, the incidence of viral control after the interruption of early antiretroviral therapy was higher among the PTCs than has been reported for spontaneous control. Off therapy, the PTCs were able to maintain and, in some cases, further reduce an extremely low viral reservoir. We found that long-lived HIV-infected CD4+ T cells contributed poorly to the total resting HIV reservoir in the PTCs because of a low rate of infection of naïve T cells and a skewed distribution of resting memory CD4+ T cell subsets. Our results show that early and prolonged cART may allow some individuals with a rather unfavorable background to achieve long-term infection control and may have important implications in the search for a functional HIV cure.
authors.affiliation: Institut Pasteur, Unité de Régulation des Infections Rétrovirales, Paris, France. asier.saez-cirion@pasteur.fr
authors.forename: Asier
authors.initials: A
authors.lastname: Sáez-Cirión
authors.forename: Charline
authors.initials: C
authors.lastname: Bacchus
authors.forename: Laurent
authors.initials: L
authors.lastname: Hocqueloux
authors.forename: Véronique
authors.initials: V
authors.lastname: Avettand-Fenoel
authors.forename: Isabelle
authors.initials: I
authors.lastname: Girault
authors.forename: Camille
authors.initials: C
authors.lastname: Lecuroux
authors.forename: Valerie
authors.initials: V
authors.lastname: Potard
authors.forename: Pierre
authors.initials: P
authors.lastname: Versmisse
authors.forename: Adeline
authors.initials: A
authors.lastname: Melard
authors.forename: Thierry
authors.initials: T
authors.lastname: Prazuck
authors.forename: Benjamin
authors.initials: B
authors.lastname: Descours
authors.forename: Julien
authors.initials: J
authors.lastname: Guergnon
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Viard
authors.forename: Faroudy
authors.initials: F
authors.lastname: Boufassa
authors.forename: Olivier
authors.initials: O
authors.lastname: Lambotte
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.forename: Laurence
authors.initials: L
authors.lastname: Meyer
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Alain
authors.initials: A
authors.lastname: Venet
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Pancino
authors.forename: Brigitte
authors.initials: B
authors.lastname: Autran
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
mesh_terms: D000483:Alleles; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000821:virology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics; D019562:Viral Load; D014766:Viremia / Q000517:prevention & control; D014779:Virus Replication
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral