EBioMedicine (Oct 2022)

Long-term antiretroviral therapy initiated in acute HIV infection prevents residual dysfunction of HIV-specific CD8+ T cells

  • Hiroshi Takata,
  • Juyeon C. Kakazu,
  • Julie L. Mitchell,
  • Eugene Kroon,
  • Donn J. Colby,
  • Carlo Sacdalan,
  • Hongjun Bai,
  • Philip K. Ehrenberg,
  • Aviva Geretz,
  • Supranee Buranapraditkun,
  • Suteeraporn Pinyakorn,
  • Jintana Intasan,
  • Somporn Tipsuk,
  • Duanghathai Suttichom,
  • Peeriya Prueksakaew,
  • Thep Chalermchai,
  • Nitiya Chomchey,
  • Nittaya Phanuphak,
  • Mark de Souza,
  • Nelson L. Michael,
  • Merlin L. Robb,
  • Elias K. Haddad,
  • Trevor A Crowell,
  • Sandhya Vasan,
  • Victor G. Valcour,
  • Daniel C. Douek,
  • Rasmi Thomas,
  • Morgane Rolland,
  • Nicolas Chomont,
  • Jintanat Ananworanich,
  • Lydie Trautmann,
  • Nipat Teeratakulpisarn,
  • Supanit Pattanachaiwit,
  • Somchai Sriplienchan,
  • Ponpen Tantivitayakul,
  • Ratchapong Kanaprach,
  • Kiat Ruxrungtham,
  • Netsiri Dumrongpisutikul,
  • Ponlapat Rojnuckarin,
  • Suthat Chottanapund,
  • Kultida Poltavee,
  • Tassanee Luekasemsuk,
  • Hathairat Savadsuk,
  • Suwanna Puttamsawin,
  • Khunthalee Benjapornpong,
  • Nisakorn Ratnaratorn,
  • Kamonkan Tangnaree,
  • Chutharat Munkong,
  • Rommanus Thaimanee,
  • Patcharin Eamyoung,
  • Sasiwimol Ubolyam,
  • Sukalya Lerdlum,
  • Sopark Manasnayakorn,
  • Rugsun Rerknimitr,
  • Sunee Sirivichayakul,
  • Phandee Wattanaboonyongcharoen,
  • Jessica Cowden,
  • Alexandra Schuetz,
  • Siriwat Akapirat,
  • Nampueng Churikanont,
  • Saowanit Getchalarat,
  • Denise Hsu,
  • Ellen Turk,
  • Oratai Butterworth,
  • Mark Milazzo,
  • Leigh Anne Eller,
  • Julie Ake,
  • Leigh Anne Eller,
  • Serena Spudich,
  • CAPT Lawrence Fox,
  • Silvia Ratto-Kim,
  • Victor DeGruttola,
  • Yotin Chinvarun,
  • Pasiri Sithinamsuwan,
  • James Fletcher,
  • Bruce Shiramizu,
  • Alexandra Schuetz

Journal volume & issue
Vol. 84
p. 104253

Abstract

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Summary: Background: Harnessing CD8+ T cell responses is being explored to achieve HIV remission. Although HIV-specific CD8+ T cells become dysfunctional without treatment, antiretroviral therapy (ART) partially restores their function. However, the extent of this recovery under long-term ART is less understood. Methods: We analyzed the differentiation status and function of HIV-specific CD8+ T cells after long-term ART initiated in acute or chronic HIV infection ex vivo and upon in vitro recall. Findings: ART initiation in any stage of acute HIV infection promoted the persistence of long-lived HIV-specific CD8+ T cells with high expansion (P<0·0008) and cytotoxic capacity (P=0·02) after in vitro recall, albeit at low cell number (P=0·003). This superior expansion capacity correlated with stemness (r=0·90, P=0·006), measured by TCF-1 expression, similar to functional HIV-specific CD8+ T cells found in spontaneous controllers. Importanly, TCF-1 expression in these cells was associated with longer time to viral rebound ranging from 13 to 48 days after ART interruption (r =0·71, P=0·03). In contrast, ART initiation in chronic HIV infection led to more differentiated HIV-specific CD8+ T cells lacking stemness properties and exhibiting residual dysfunction upon recall, with reduced proliferation and cytolytic activity. Interpretation: ART initiation in acute HIV infection preserves functional HIV-specific CD8+ T cells, albeit at numbers too low to control viral rebound post-ART. HIV remission strategies may need to boost HIV-specific CD8+ T cell numbers and induce stem cell-like properties to reverse the residual dysfunction persisting on ART in people treated after acute infection prior to ART release. Funding: U.S. National Institutes of Health and U.S. Department of Defense.

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