Search

BackgroundEarly combined antiretroviral therapy (cART) limits the total HIV-DNA load in children. However, data on its impact in older children and adolescents remain scarce. This study compares HIV reservoirs in children (5–12 years) and adolescents (13–17 years) who started cART 2 years (late [L-] group).MethodsThe ANRS-EP59-CLEAC study prospectively enrolled 76 patients perinatally infected with HIV-1 who reached HIV-RNA ResultsTotal HIV-DNA levels were lower in early- versus late-treated patients (children: 2.14 vs 2.87 log copies/million PBMCs; adolescents: 2.25 vs 2.74 log; P < .0001 for both). Low reservoir was independently associated with treatment precocity, protective HLA, and low cumulative viremia since cART initiation. The 60 participants with undetectable integrated HIV-DNA started cART earlier than other patients (4 vs 54 months; P = .03). In those with sustained virological control, transitional and effector memory CD4+ T cells were less infected in the E-group than in the L-group (P = .03 and .02, respectively). Viral inducibility of reservoir cells after normalization to HIV-DNA levels was similar between groups.ConclusionsEarly cART results in a smaller blood HIV reservoir until adolescence, but all tested participants had an inducible reservoir. This deserves cautious consideration for HIV remission strategies.

HLA-A*02 tetramers complexed to human immunodeficiency virus (HIV) Gag SLYNTVATL and HIV Pol ILKEPVHGV peptides were used to characterize HLA class I-restricted CD8(+) T cells in 41 HIV-infected children. The frequencies and the phenotype of specific circulating CD8(+) T cells were determined in whole-blood samples by means of cytometric analysis. Background staining of 13 HLA-A*02-negative patients showed that the frequency of CD8(+) T cells was

A vaccine against human immunodeficiency virus (HIV) should induce virus-specific cytotoxic T lymphocyte (CTL) activity. Immunization of uninfected volunteers with a canarypox virus express­ ing HIV envelope was carried out in a phase I trial. Two injections of canarypox expressing HIV­ l M N gp160 (months 0 and 1) were followed by two boosts of recombinant envelope protein (months 3 and 6). HIV envelope-specific CTL were detected in peripheral blood mononuclear cells stimulated with autologous HIV-l-infected blast cells. T cell lines were obtained from 18 of 20 donors: CTL were detected at least once following immunization in 7 (39%) of these 18. This activity was mediated by major histocompatibility complex class I-restricted CD3+CD8+ T cells. For two subjects, this activity was still present 2 years after the initial immunization. The CTL responses with this prime­ boost regimen are the best observed with any HIV vaccine tested in humans. Vaccination against the human immunodeficiency virus type I (HIV-I) is a key strategy for the eventual control of the AIDS pandemic. Since the discovery of the etiologic agent of AIDS, different candidate vaccines have been designed and developed, including whole killed virus, live attenuated virus, virus-like particles including pseudovirions, protein subunits based on HIV structural genes, peptides based on selected im­ munoreactive parts of the viral proteins, live recombinant viral or bacterial vectors, and DNA-based immunogens encoding one or more HIV proteins [1-3]. Live recombinant vaccinia viruses have been used successfully to induce protective immu­ nity against animal infectious diseases such as rabies [4], but because the use ofvaccinia virus for human vaccination against smallpox has been shown to induce rare but serious complica­ tions [5], other recombinant poxviruses such as avian poxvi­ ruses have been developed [6, 7]. As was the case for most live expression vectors in AIDS vaccine studies, initial efforts have focused on products based on the HIV-I envelope protein, since several epitopes of env have been described to induce neutralizing antibodies and cell-mediated immune responses, including cytotoxic T lymphocytes (CTL). In HIV-seronegative volunteers at low risk ofHIV infection, the safety and immuno

SUMMARY The HIV gag polyprotein is a major target for recognition by CTL in infected humans. Using recombinant vaccinia viruses (rVV) expressing truncations of the p24gag, and the p18gag, p15gagand HIV-2 p56gag proteins, the characterization of epitope regions recognized by in vitro-stimulated peripheral blood mononuclear ceils (PBMC) from 18 infected patients has been studied. The gag-specific response of most individuals is polyclonal and multispecific, and inter-individual variations between target epitope regions were frequently observed, despite shared MHC alleles. As CTL may play an important role in the control of HIV replication in infected hosts, these results have important implications for designing vaccine strategies.