TY - JOUR
T1 - Permanent control of HIV-1 pathogenesis in exceptional elite controllers
T2 - a model of spontaneous cure
AU - Casado, Concepcion
AU - Galvez, Cristina
AU - Pernas, Maria
AU - Tarancon-Diez, Laura
AU - Rodriguez, Carmen
AU - Sanchez-Merino, Víctor
AU - Vera, Mar
AU - Olivares, Isabel
AU - De Pablo-Bernal, Rebeca
AU - Merino-Mansilla, Alberto
AU - Del Romero, Jorge
AU - Lorenzo-Redondo, Ramon
AU - Ruiz-Mateos, Ezequiel
AU - Salgado, María
AU - Martinez-Picado, Javier
AU - Lopez-Galindez, Cecilio
N1 - Funding Information:
The authors want to acknowledge the three infected individuals for their continuos and generous contribution. Also to Andreas Meyerhans and Rowena Johnston (amfAR) for the critical reading of the manuscript. To Rosa Fuentes for her technical assitance in CNM. To Dr. Lucia Perez-Alvarez and Dr. Angel Pajares Herraiz (Hospital Virgen de la Salud de Toledo) for their assistance for the blood extraction. To Almudena Lillo, Inmaculada Cabeza and Juan Luis Cotano for their technical support in Centro Sandoval. To Dr. V. Estrada and the nurses in the Infectious Disease Deparment in the Hospital Clinico San Carlos. We would like to thank Á. Hernández Rodríguez, B. Rivaya and V. González Soler from Microbiology Department at Hospital Germans Trias i Pujol.Work in Centro Nacional de Microbiologia (ISCIII) was supported by grants SAF (2016–77894-R) from Ministerio de Economia y Competitividad (MINECO) (Spain) and Fondo de Investigación Sanitaria (FIS)-Instituto de Salud CarlosIII, grant FIS (PI 13/02269, ISCIII) and in part by the RIS-RETIC grants RD12/0017/0028 and RD16CIII/0002/0005 funded by the ISCIII-FEDER. MP has a contract of RIS-RETIC RD16CIII/0002/0005. This work was supported by grants from the MINECO, FIS-Instituto de Salud CarlosIII, Fondos Europeos para el Desarrollo Regional, FEDER, grant numbers PI16/00684, PI19/01127, CPII014/00025 to ER-M. and FI14/00431 to LT-D.; the Gilead Fellowship Program (grant numbers GLD17/00299); the Red de Investigación en Sida (grant number RD16/0025/0020). ER-M. is supported by Consejería de Salud y Bienestar Social of Junta de Andalucía through the Nicolás Monardes Program (C-0032/17). Research in VS-M group was supported by Fondo de Investigación Sanitaria (FIS)-Instituto de Salud CarlosIII, grant FIS (PI 17CIII/00049). Grifols partially supported work in the AIDS Research Institute IrsiCaixa. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Elite controllers (EC) represent a small subset of HIV-1-infected people that spontaneously control viral replication. However, natural virological suppression and absence of immune dysfunction are not always long-term sustained. We define exceptional EC (EEC) as HIV-1 subjects who maintain the EC characteristics without disease progression for more than 25 years. We analyzed three EEC, diagnosed between 1988 and 1992, who never showed signs of clinical disease progression in absence of any antiretroviral treatment. A comprehensive clinical, virological, and immunological study was performed. The individuals simultaneously exhibited ≥3 described host protective alleles, low levels of total HIV-1 DNA (<20 copies/106 CD4+ T-cells) without evidence of replication-competent viruses (<0.025 IUPM), consistent with high levels of defective genomes, strong cellular HIV-1-specific immune response, and a high poly-functionality index (>0.50). Inflammation levels of EEC were similar to HIV-1 negative donors. Remarkably, they showed an exceptional lack of viral evolution and 8-fold lower genetic diversity (<0.01 s/n) in env gene than other EC. We postulate that these EEC represent cases of spontaneous functional HIV-1 cure. A non-functional and non-genetically evolving viral reservoir along with an HIV-1-specific immune response seems to be key for the spontaneous functional cure.
AB - Elite controllers (EC) represent a small subset of HIV-1-infected people that spontaneously control viral replication. However, natural virological suppression and absence of immune dysfunction are not always long-term sustained. We define exceptional EC (EEC) as HIV-1 subjects who maintain the EC characteristics without disease progression for more than 25 years. We analyzed three EEC, diagnosed between 1988 and 1992, who never showed signs of clinical disease progression in absence of any antiretroviral treatment. A comprehensive clinical, virological, and immunological study was performed. The individuals simultaneously exhibited ≥3 described host protective alleles, low levels of total HIV-1 DNA (<20 copies/106 CD4+ T-cells) without evidence of replication-competent viruses (<0.025 IUPM), consistent with high levels of defective genomes, strong cellular HIV-1-specific immune response, and a high poly-functionality index (>0.50). Inflammation levels of EEC were similar to HIV-1 negative donors. Remarkably, they showed an exceptional lack of viral evolution and 8-fold lower genetic diversity (<0.01 s/n) in env gene than other EC. We postulate that these EEC represent cases of spontaneous functional HIV-1 cure. A non-functional and non-genetically evolving viral reservoir along with an HIV-1-specific immune response seems to be key for the spontaneous functional cure.
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U2 - 10.1038/s41598-020-58696-y
DO - 10.1038/s41598-020-58696-y
M3 - Article
C2 - 32024974
AN - SCOPUS:85079070494
VL - 10
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
IS - 1
M1 - 1902
ER -
