Réservoirs viraux et contrôle immunitaire

Achilles’ heel for reseeding of the viral reservoir after stem cell transplantation in people with HIV

Current HIV treatments efficiently block viral multiplication but cannot cure infection as they do not target HIV infected cells. HIV cure or profound HIV remission have been described in three persons with HIV who underwent allogeneic stem cell transplantation to treat severe blood cancers. However, this procedure has not eradicated the virus in other persons. A work led by scientists from the University Medical Center Hamburg and Institut Pasteur in the context of the ICISTEM international consortium has analyzed the evolution of the immune system in 16 persons with HIV after allogeneic stem cell transplantation. The scientists identified a phase of strong activation of the immune system occurring after the transplant which may provide a window of vulnerability for the reseeding of the HIV reservoir in the expanding donor cells. Their findings are published in the journal Science Translational Medicine on May 6, 2020.

HIV: reprogramming cells to control infection

Cells from the rare individuals who naturally control HIV infection have been the focus of investigation for nearly 15 years with the aim of elucidating their specific features. Following research on the ANRS CO21 CODEX and CO6 PRIMO cohorts, scientists from the Institut Pasteur have described the characteristics of CD8 immune cells in these “HIV controller” subjects. The unique antiviral power of these immune cells can be attributed to an optimal metabolic program that confers persistence and the ability to react effectively against infected cells. Working ex vivo, the scientists successfully reprogrammed cells from infected non-controller individuals to give them the same antiviral potency as controllers’ cells. Their findings are published in the journal Nature Metabolism on July 12, 2019.

AIDS: An approach for targeting HIV reservoirs

Current HIV treatments need to be taken for life by those infected as antiretroviral therapy is unable to eliminate viral reservoirs lurking in immune cells. Scientists have identified the characteristics of CD4 T lymphocytes that are preferentially infected by the virus. Thanks to metabolic activity inhibitors, the researchers have managed to destroy these infected cells, or ‘reservoirs’, ex vivo. Cell Metabolism, March 2019

Des “supers” lymphocytes T CD8 contribuent au contrôle naturel du VIH-2

Chez les personnes infectées par le VIH-2, la maladie ne progresse que rarement, même sans traitement. Il apparaît qu’elles disposent de ressources remarquables en lymphocytes CD8, particulièrement efficaces pour éliminer les cellules hébergeant le virus. Lire l’actualité complète sur le site de l’Inserm

HIV cure study (ICISTEM) provides insight into 2008 case (CNN.com)

The first results of the ICISTEM study were presented at the IAS AIDS 2016 conference in Durban, South Africa. Read the note about ICISTEM (before EPISTEM) published at CNN.com 

First case of prolonged remission (12 years) in an HIV-infected child

A young woman now aged 18 and a half, who at birth was HIV-infected via mother-to-child transmission (during pregnancy or at delivery), is in virological remission, despite not having taken any antiretroviral therapy for the last 12 years. Monitored in the French ANRS pediatric cohort, this young woman seems to have benefited from the treatment that was initiated shortly after her birth and stopped approximately six years later. Her case suggests that long-term remission after early treatment is possible in children infected by HIV since birth, as demonstrated in adults in the ANRS VISCONTI study.

This first case in the world of long-term remission in a child was presented as an oral communication (MOAA0105LB) by Dr Asier Sáez-Cirión (HIV, Inflammation and Persistence Unit, Institut Pasteur, Paris) at the 8th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention held from 19 to 22 July 2015 in Vancouver, Canada. This work, supported by the ANRS, was conducted by research teams at the Institut Pasteur, Inserm and Paris university hospitals. The first case of prolonged remission in an HIV-infected child – an interview with Asier Saez-Cirion

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