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Tamalet C, Colson P, Decroly E, Dhiver C, Ravaux I, Stein A, Raoult D. Reevaluation of possible outcomes of infections with human immunodeficiency virus. Clin Microbiol Infect 2016; 22:299-311. [PMID: 26794031 DOI: 10.1016/j.cmi.2015.11.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/15/2015] [Accepted: 11/21/2015] [Indexed: 02/05/2023]
Abstract
Several lines of evidence indicate that HIV infection can result in several possible incomes, including a very small proportion of individuals whose HIV replication is controlled after treatment interruption (known as HIV posttreatment controllers) or spontaneously without any treatment (known as HIV elite controllers). Both types of individuals are HIV RNA negative but HIV DNA positive, with living virus which can be stimulated ex vivo. A review was conducted to assess the literature on yet rarer cases with detectable integrated HIV DNA without HIV infectious virus in HIV-seropositive or -negative individuals. Three categories of patients were identified: (a) HIV-seropositive individuals with apparent spontaneous cure from their HIV infection, (b) HIV-seronegative children born to HIV-infected mothers and (c) highly exposed seronegative adults. Validity criteria were proposed to assess the presence of integrated HIV DNA as possible or unquestionable in these three categories. Only three articles among the 22 ultimately selected fulfilled these criteria. Among the highly exposed seronegative subjects, some individuals were described as being without integrated HIV DNA, probably because these subjects were not investigated using relevant, highly sensitive methods. Finally, we propose a definition of spontaneous cure of HIV infection based on clinical, immunologic and virologic criteria.
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Affiliation(s)
- C Tamalet
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France
| | - P Colson
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France
| | - E Decroly
- Aix-Marseille University, CNRS AFMB Laboratory, UMR 7257, Case 925, France
| | - C Dhiver
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France
| | - I Ravaux
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France
| | - A Stein
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France
| | - D Raoult
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France.
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Gianesin K, Petrara R, Freguja R, Zanchetta M, Giaquinto C, De Rossi A. Host factors and early treatments to restrict paediatric HIV infection and early disease progression. J Virus Erad 2015; 1:140-7. [PMID: 27482405 PMCID: PMC4946731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
A body of evidence indicates that a threshold level of the virus is required to establish systemic and persistent HIV infection in the host and that this level depends on virus-host interactions. Mother-to-child transmission (MTCT) of HIV is the main source of paediatric HIV infection and occurs when the host's immune system is still developing. Thus, innate resistance and immunity, rather than adaptive immune response, may be the main drivers in restricting the establishment of HIV reservoirs and the long-lived persistence of HIV infection in infants. Genetic variations in HIV co-receptors and their ligands, as well as in Toll-like receptors and defensins, key elements of innate immunity, have been demonstrated to influence the risk of perinatal HIV infection and disease progression in HIV-infected infants. Early treatments with combined antiretroviral therapy (cART) restrict paediatric infection by reducing the level of the transmitted/infecting virus to below the threshold required for the onset of immune response to the virus and also significantly reduce HIV reservoirs. However, despite long periods with no signs and symptoms of HIV infection, all early cART-treated children who later discontinued cART had a rebound of HIV, except for one case in whom a period of viral remission occurred. Which parameters predict viral remission or viral rebound after cART discontinuation? Could early cART prevent rather than just reduce the establishment of viral reservoirs? And, if so, how? Answers to these questions are also important in order to optimise the use of early cART in infants at high risk of HIV infection.
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Affiliation(s)
- Ketty Gianesin
- Section of Oncology and Immunology, AIDS Reference Center, Department of Oncology and Immunology,
University of Padua,
Italy
| | - Raffaella Petrara
- Section of Oncology and Immunology, AIDS Reference Center, Department of Oncology and Immunology,
University of Padua,
Italy,Centro di Riferimento Oncologico (CRO)-IRCCS,
Aviano,
Italy
| | - Riccardo Freguja
- Section of Oncology and Immunology, AIDS Reference Center, Department of Oncology and Immunology,
University of Padua,
Italy,Penta Foundation,
Padua,
Italy
| | | | - Carlo Giaquinto
- Penta Foundation,
Padua,
Italy,Department of Mother and Child Health,
University of Padua,
Italy
| | - Anita De Rossi
- Section of Oncology and Immunology, AIDS Reference Center, Department of Oncology and Immunology,
University of Padua,
Italy,Istituto Oncologico Veneto (IOV)-IRCCS,
Padua,
Italy,Corresponding author: Anita De Rossi,
Section of Oncology and Immunology, AIDS Reference Center, Department of Surgery, Oncology and Gastroenterology,
University of PaduaVia Gattamelata 64,
35128Padua,
Italy
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Gianesin K, Petrara R, Freguja R, Zanchetta M, Giaquinto C, De Rossi A. Host factors and early treatments to restrict paediatric HIV infection and early disease progression. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)30509-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Vázquez-Pérez JA, Ormsby CE, Hernández-Juan R, Torres KJ, Reyes-Terán G. APOBEC3G mRNA expression in exposed seronegative and early stage HIV infected individuals decreases with removal of exposure and with disease progression. Retrovirology 2009; 6:23. [PMID: 19254362 PMCID: PMC2661038 DOI: 10.1186/1742-4690-6-23] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 03/02/2009] [Indexed: 12/26/2022] Open
Abstract
Background APOBEC3G is an antiretroviral factor that acts by inducing G to A mutations. In this study, we examined the expression of APOBEC3G in uninfected HIV-1 exposed individuals at the time of their partner's diagnosis and one year later. We then compared this expression with that of infected individuals at different disease stages. APOBEC3G mRNA was measured in PBMCs from three groups: healthy controls with no known risk factor to HIV infection (n = 26), exposed uninfected individuals who had unprotected sex with their HIV+ partners for at least 3 months (n = 37), and HIV infected patients at various disease stages (n = 45), including 8 patients with low HIV viral loads < 10,000 copies/mL (LVL) for at least 3 years. Additionally, we obtained sequences from the env, gag, pol, nef, vif and the LTR of the patients' virus. Results Exposed uninfected individuals expressed higher APOBEC3G than healthy controls (3.86 vs. 1.69 relative expression units), and their expression significantly decreased after a year from the HIV diagnosis and subsequent treatment of their partners. Infected individuals showed a positive correlation (Rho = 0.57, p = 0.00006) of APOBEC3G expression with CD4+ T cell count, and a negative correlation with HIV viremia (Rho = -0.54, p = 0.00004). The percentage of G to A mutations had a positive correlation (Rho = 0.43, p = 0.0226) with APOBEC3G expression, and it was higher in LVL individuals than in the other patients (IQR 8.27 to 9.64 vs. 7.06 to 8.1, p = 0.0084). Out of 8 LVLs, 3 had hypermutations, and 4 had premature stop codons only in viral vif. Conclusion The results suggest that exposure to HIV may trigger APOBEC3G expression in PBMCs, in the absence of infection. Additionally, cessation of exposure or advanced disease is associated with decreased APOBEC3G expression.
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Affiliation(s)
- Joel A Vázquez-Pérez
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, México City, México.
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