Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.

Upon interruption of antiretroviral therapy, HIV-infected patients usually show viral load rebound to pre-treatment levels. Four patients, hereafter referred to as secondary controllers (SC), were identified who initiated therapy during chronic infection and, after stopping treatment, could control...

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Main Authors: Ellen Van Gulck, Lotte Bracke, Leo Heyndrickx, Sandra Coppens, Derek Atkinson, Céline Merlin, Alexander Pasternak, Eric Florence, Guido Vanham
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3364270?pdf=render
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author Ellen Van Gulck
Lotte Bracke
Leo Heyndrickx
Sandra Coppens
Derek Atkinson
Céline Merlin
Alexander Pasternak
Eric Florence
Guido Vanham
author_facet Ellen Van Gulck
Lotte Bracke
Leo Heyndrickx
Sandra Coppens
Derek Atkinson
Céline Merlin
Alexander Pasternak
Eric Florence
Guido Vanham
author_sort Ellen Van Gulck
collection DOAJ
description Upon interruption of antiretroviral therapy, HIV-infected patients usually show viral load rebound to pre-treatment levels. Four patients, hereafter referred to as secondary controllers (SC), were identified who initiated therapy during chronic infection and, after stopping treatment, could control virus replication at undetectable levels for more than six months. In the present study we set out to unravel possible viral and immune parameters or mechanisms of this phenomenon by comparing secondary controllers with elite controllers and non-controllers, including patients under HAART. As candidate correlates of protection, virus growth kinetics, levels of intracellular viral markers, several aspects of HIV-specific CD4+ and CD8+ T cell function and HIV neutralizing antibodies were investigated. As expected all intracellular viral markers were lower in aviremic as compared to viremic subjects, but in addition both elite and secondary controllers had lower levels of viral unspliced RNA in PBMC as compared to patients on HAART. Ex vivo cultivation of the virus from CD4+ T cells of SC consistently failed in one patient and showed delayed kinetics in the three others. Formal in vitro replication studies of these three viruses showed low to absent growth in two cases and a virus with normal fitness in the third case. T cell responses toward HIV peptides, evaluated in IFN-γ ELISPOT, revealed no significant differences in breadth, magnitude or avidity between SC and all other patient groups. Neither was there a difference in polyfunctionality of CD4+ or CD8+ T cells, as evaluated with intracellular cytokine staining. However, secondary and elite controllers showed higher proliferative responses to Gag and Pol peptides. SC also showed the highest level of autologous neutralizing antibodies. These data suggest that higher T cell proliferative responses and lower replication kinetics might be instrumental in secondary viral control in the absence of treatment.
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spelling doaj.art-11cb7ce5e6fe42df850165670045a4852022-12-22T02:34:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0175e3779210.1371/journal.pone.0037792Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.Ellen Van GulckLotte BrackeLeo HeyndrickxSandra CoppensDerek AtkinsonCéline MerlinAlexander PasternakEric FlorenceGuido VanhamUpon interruption of antiretroviral therapy, HIV-infected patients usually show viral load rebound to pre-treatment levels. Four patients, hereafter referred to as secondary controllers (SC), were identified who initiated therapy during chronic infection and, after stopping treatment, could control virus replication at undetectable levels for more than six months. In the present study we set out to unravel possible viral and immune parameters or mechanisms of this phenomenon by comparing secondary controllers with elite controllers and non-controllers, including patients under HAART. As candidate correlates of protection, virus growth kinetics, levels of intracellular viral markers, several aspects of HIV-specific CD4+ and CD8+ T cell function and HIV neutralizing antibodies were investigated. As expected all intracellular viral markers were lower in aviremic as compared to viremic subjects, but in addition both elite and secondary controllers had lower levels of viral unspliced RNA in PBMC as compared to patients on HAART. Ex vivo cultivation of the virus from CD4+ T cells of SC consistently failed in one patient and showed delayed kinetics in the three others. Formal in vitro replication studies of these three viruses showed low to absent growth in two cases and a virus with normal fitness in the third case. T cell responses toward HIV peptides, evaluated in IFN-γ ELISPOT, revealed no significant differences in breadth, magnitude or avidity between SC and all other patient groups. Neither was there a difference in polyfunctionality of CD4+ or CD8+ T cells, as evaluated with intracellular cytokine staining. However, secondary and elite controllers showed higher proliferative responses to Gag and Pol peptides. SC also showed the highest level of autologous neutralizing antibodies. These data suggest that higher T cell proliferative responses and lower replication kinetics might be instrumental in secondary viral control in the absence of treatment.http://europepmc.org/articles/PMC3364270?pdf=render
spellingShingle Ellen Van Gulck
Lotte Bracke
Leo Heyndrickx
Sandra Coppens
Derek Atkinson
Céline Merlin
Alexander Pasternak
Eric Florence
Guido Vanham
Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.
PLoS ONE
title Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.
title_full Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.
title_fullStr Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.
title_full_unstemmed Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.
title_short Immune and viral correlates of "secondary viral control" after treatment interruption in chronically HIV-1 infected patients.
title_sort immune and viral correlates of secondary viral control after treatment interruption in chronically hiv 1 infected patients
url http://europepmc.org/articles/PMC3364270?pdf=render
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