Frontiers in Immunology (Mar 2021)

Residual Viremia Is Linked to a Specific Immune Activation Profile in HIV-1-Infected Adults Under Efficient Antiretroviral Therapy

  • Mehwish Younas,
  • Christina Psomas,
  • Christina Psomas,
  • Christelle Reynes,
  • Renaud Cezar,
  • Lucy Kundura,
  • Pierre Portalès,
  • Corinne Merle,
  • Nadine Atoui,
  • Céline Fernandez,
  • Vincent Le Moing,
  • Vincent Le Moing,
  • Vincent Le Moing,
  • Claudine Barbuat,
  • Albert Sotto,
  • Albert Sotto,
  • Robert Sabatier,
  • Audrey Winter,
  • Pascale Fabbro,
  • Thierry Vincent,
  • Thierry Vincent,
  • Jacques Reynes,
  • Jacques Reynes,
  • Jacques Reynes,
  • Pierre Corbeau,
  • Pierre Corbeau,
  • Pierre Corbeau

DOI
https://doi.org/10.3389/fimmu.2021.663843
Journal volume & issue
Vol. 12

Abstract

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Chronic immune activation persists in persons living with HIV-1 even though they are aviremic under antiretroviral therapy, and fuels comorbidities. In previous studies, we have revealed that virologic responders present distinct profiles of immune activation, and that one of these profiles is related to microbial translocation. In the present work, we tested in 140 HIV-1-infected adults under efficient treatment for a mean duration of eight years whether low-level viremia might be another cause of immune activation. We observed that the frequency of viremia between 1 and 20 HIV-1 RNA copies/mL (39.5 ± 24.7% versus 21.1 ± 22.5%, p = 0.033) and transient viremia above 20 HIV-1 RNA copies/mL (15.1 ± 16.9% versus 3.3 ± 7.2%, p = 0.005) over the 2 last years was higher in patients with one profile of immune activation, Profile E, than in the other patients. Profile E, which is different from the profile related to microbial translocation with frequent CD38+ CD8+ T cells, is characterized by a high level of CD4+ T cell (cell surface expression of CD38), monocyte (plasma concentration of soluble CD14), and endothelium (plasma concentration of soluble Endothelial Protein C Receptor) activation, whereas the other profiles presented low CD4:CD8 ratio, elevated proportions of central memory CD8+ T cells or HLA-DR+ CD4+ T cells, respectively. Our data reinforce the hypothesis that various etiological factors shape the form of the immune activation in virologic responders, resulting in specific profiles. Given the type of immune activation of Profile E, a potential causal link between low-level viremia and atherosclerosis should be investigated.

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