Abstract
BackgroundSome HIV infected individuals remain asymptomatic for protracted periods of time in the absence of antiretroviral therapy (ART). Virological control, CD4 T cell loss and HIV-specific responses are some of the key interrelated determinants of HIV-1 disease progression. In this study, possible interactions between viral load, CD4 T cell slopes, host genetics and HIV-specific IFN-γ responses were evaluated in chronically HIV-1-infected adults.Methodolology/Principal FindingsMultilevel regression modeling was used to stratify clade A or D HIV-infected individuals into disease progression groups based on CD4 T cell slopes. ELISpot assays were used to quantify the frequency and magnitude of HIV-induced IFN-γ responses in 7 defined rapid progressors (RPs) and 14 defined slow progressors (SPs) at a single time point. HLA typing was performed using reference strand conformational analysis (RSCA). Although neither the breadth nor the magnitude of the proteome-wide HIV-specific IFN-γ response correlated with viral load, slow disease progression was associated with over-representation of host immunogenetic protective HLA B* alleles (10 of 14 SPs compared to 0 of 7; p = 0.004, Fisher's Exact) especially B*57 and B*5801, multiclade Gag T-cell targeting (71%, 10 of 14 SPs compared to 14%, 1 of 7 RPs); p = 0.029, Fisher's Exact test and evident virological control (3.65 compared to 5.46 log10 copies/mL in SPs and RPs respectively); p<0.001, unpaired student's t-testConclusionsThese data are consistent with others that associated protection from HIV disease with inherent host HLA B allele-mediated ability to induce broader Gag T-cell targeting coupled with apparent virological control. These immunogenetic features of Gag-specific immune response which could influence disease progression may provide useful insight in future HIV vaccine design.
Highlights
There is urgent need for a protective human immunodeficiency virus (HIV) vaccine, the correlates of effective immune protection from HIV-1 infection remain unclear
These data are consistent with others that associated protection from HIV disease with inherent host HLA B allele-mediated ability to induce broader Gag T-cell targeting coupled with apparent virological control
Cohort stratification Retrospective six-monthly CD4 T-cell counts were utilised in a multilevel regression model to stratify the cohort into HIV disease progression groups based on individual participant CD4 slopes
Summary
There is urgent need for a protective human immunodeficiency virus (HIV) vaccine, the correlates of effective immune protection from HIV-1 infection remain unclear. Some antiretroviral drug naıve HIV infected individuals remain asymptomatic for protracted periods showing relatively lower levels of plasma viral RNA and stable CD4 counts, and this beneficial state has been attributed to complex features associated with viral, host genetic and environmental factors These features include slow or arrested viral evolution [14,15,16]; HIV subtype variation [17,18]; a broadly directed T-cell response mostly targeting Gag [2,9,11,19]; heterozygosity for the CCR5 D32 HIV receptor; enrichment of certain HLA haplotypes and HIV polymorphisms [20,21,22] and lack of immune activation [23].
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