Deciphering natural control of HIV-1: A valuable strategy to achieve antiretroviral therapy termination. (April 2018)

• Record Type: Journal Article
• Authors: Loucif, Hamza; Gouard, Steven; Dagenais-Lussier, Xavier; Murira, Armstrong; Stäger, Simona; Tremblay, Cécile; Van Grevenynghe, Julien
• Is Part Of: Cytokine & growth factor reviews. Volume 40(2018)
• Page Start: 90
• Page End: 98
• Publication Date: 2018-04
• Subjects: HIV-1 -- Cure -- ART -- Controllers -- Inflammation -- Metabolism -- Antiviral immunity -- Microbiota; Cytokines -- Periodicals; 571.84
• DOI: 10.1016/j.cytogfr.2018.03.010
• Languages: English
• ISSNs: 1359-6101

Abstract

Highlights: Modern ART fails to cure HIV-1 infection. Modern ART, even with early administration, is associated with inflammation and immune dysfunctions. HIV-1 controllers display preserved antiviral immune protection despite inflammation. HIV-1 controllers have gut integrity and microbiota richness similar to uninfected controls. HIV-1 controllers can be employed to advance cure research and achieve ART termination. Abstract: Antiretroviral therapy (ART) has dramatically reduced HIV-1-associated morbidity and mortality, and has transformed HIV-1 infection into a manageable chronic condition by suppressing viral replication. However, despite recent patient care improvements, ART still fails to cure HIV-1 infection due to the inability to counteract immune defects and metabolic disturbances that are associated with residual inflammation alongside viral persistence. Life-long drug administration also results in multiple side-effects in patients including lipodystrophy and insulin resistance. Thus, it is critical to find new ways to reduce the length of treatment and facilitate the termination of ART, for example by boosting protective immunity. The rare ability of some individuals to naturally control HIV-1 infection despite residual inflammation could be exploited to identify molecular mechanisms involved in host protection that may function as potential therapeutic targets. In this review, we highlight evidence illustrating the molecular and metabolic advantages of HIV-1 controllers over ART treated patients that contribute to the maintenance of effective antiviral immunity.