Abstract

BackgroundHIV-2 infection is characterised by a longer asymptomatic phase and slower AIDS progression than HIV-1 infection. Identifying unique immune signatures associated with HIV-2 pathogenesis may thus provide therapeutically useful insight into the management of HIV infection. This study examined the dynamics of the CD4+T cell compartment, critical in disease progression, focussing on chronic HIV-2 and HIV-1 infected individuals at various stages of disease progression.MethodsA total of 111 participants including untreated and treated HIV infected individuals and seronegative individuals were enrolled in this study. The relative proportion of CD4+T cell subsets, expressing CD25 (IL-2Rα) and CD127 (IL-7R), in HIV infected individuals and seronegative controls were assessed by multiparametric flow cytometry. Additionally, levels of immune activation and cytotoxic T lymphocytes in both the CD4+T and CD8+T cell compartments was evaluated.ResultsBoth treated and untreated, HIV-1 and HIV-2 infected individuals showed apparent dysregulation in CD4+ T cell subset frequency that was associated with disease progression. Furthermore, longitudinal sampling from a group of HIV-1 infected individuals on virologically effective ART showed no significant change in dysregulated CD4+T cell subset frequency. For both ART naïve and receiving groups associations with disease progression were strongest and significant with CD4+ T cell subset frequency compared to per cell expression of IL-2Rα and IL-7Rα. In untreated HIV-2 infected individuals, T cell activation was lower compared to ART naïve HIV-1 infected individuals and higher than seronegative individuals. Also, the level of Granzyme-B expressing circulating T cells was higher in both ART-naïve HIV-1 and HIV-2 infected individuals compared to seronegative controls.ConclusionDysregulation of IL-2 and IL-7 homeostasis persists in CD4+T cell subsets irrespective of presence or absence of viremia or antiretroviral therapy in HIV infection. Furthermore, we report for the first time on levels of circulating Granzyme-B expressing CD4+T and CD8+T cells in chronic HIV-2 infection. Lower immune activation in these individuals indicates that persistent immune activation driven CD4+T cell depletion, as observed in untreated HIV-1 infected individuals, may not be as severe and provides evidence for a disparate pathogenesis mechanism. Our work also supports novel immunomodulatory therapeutic strategies for both HIV-1 and HIV-2 infection.

Highlights

  • HIV-2 infection is characterised by a longer asymptomatic phase and slower AIDS progression than HIV-1 infection

  • The dynamics of the CD4+T cell compartment may differ based on the presence or absence of active viral replication, we have evaluated the relative proportions of three subsets of CD4+ T cells that are defined based on expression of CD127 and CD25 under anti-retroviral therapy (ART) naïve and therapy receiving conditions in both HIV-1 and HIV-2 infected individuals

  • HIV-1 and HIV-2 infected ART-naïve individuals When the relative proportions of these CD4+T cell subsets were examined in ART-naïve HIV-1 and HIV-2 infected individuals, we observed a significant increase in the frequency of the Tregs (CD25highCD127low) subset (P = < 0.0001 for HIV-1; P = < 0.0001 for HIV-2) and effector memory (CD127−CD25−) subset (P = < 0.0001 for HIV-1; P = < 0.0001 for HIV-2), and a decline in the fraction of naive/central memory (CD127+CD25low/−) T cell subset (P = < 0.0001 for HIV-1; P = < 0.0001 for HIV-2) in both HIV-1 and HIV-2 infected individuals as compared to seronegative controls

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Summary

Introduction

HIV-2 infection is characterised by a longer asymptomatic phase and slower AIDS progression than HIV-1 infection. HIV-2 single infection and dual (HIV-1 along with HIV-2) infection is clearly present and persistent in the HIV infected population in India [4, 5] Both HIV-1 and HIV-2 share the same modes of transmission, namely sexual contact, blood-borne exposure (blood transfusion, shared needles) and perinatal transmission. Both infections are associated with a progressive decline of CD4+T cells and loss of immune function, which manifests clinically as an increased susceptibility to opportunistic infections. HIV-2 infection has been associated with a significantly longer asymptomatic stage, lower plasma viral load, slower decline in CD4+T-cell count, and lower mortality rate attributable to AIDS compared to HIV-1 [6,7,8]. A well-preserved and polyfunctional HIV-specific memory CD4+T cell response has been shown to be a hall mark of HIV-2 infection [9, 10]

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