[HTML][HTML] Increased homeostatic cytokines and stability of HIV-infected memory CD4 T-cells identify individuals with suboptimal CD4 T-cell recovery on-ART

M Pino, S Pereira Ribeiro, A Pagliuzza… - PLoS …, 2021 - journals.plos.org
M Pino, S Pereira Ribeiro, A Pagliuzza, K Ghneim, A Khan, E Ryan, JL Harper, CT King…
PLoS Pathogens, 2021journals.plos.org
Clinical outcomes are inferior for individuals with HIV having suboptimal CD4 T-cell recovery
during antiretroviral therapy (ART). We investigated if the levels of infection and the
response to homeostatic cytokines of CD4 T-cell subsets contributed to divergent CD4 T-cell
recovery and HIV reservoir during ART by studying virologically-suppressed immunologic
responders (IR, achieving a CD4 cell count> 500 cells/μL on or before two years after ART
initiation), and virologically-suppressed suboptimal responders (ISR, did not achieve a CD4 …
Clinical outcomes are inferior for individuals with HIV having suboptimal CD4 T-cell recovery during antiretroviral therapy (ART). We investigated if the levels of infection and the response to homeostatic cytokines of CD4 T-cell subsets contributed to divergent CD4 T-cell recovery and HIV reservoir during ART by studying virologically-suppressed immunologic responders (IR, achieving a CD4 cell count >500 cells/μL on or before two years after ART initiation), and virologically-suppressed suboptimal responders (ISR, did not achieve a CD4 cell count >500 cells/μL in the first two years after ART initiation). Compared to IR, ISR demonstrated higher levels of HIV-DNA in naïve, central (CM), transitional (TM), and effector (EM) memory CD4 T-cells in blood, both pre- and on-ART, and specifically in CM CD4 T-cells in LN on-ART. Furthermore, ISR had higher pre-ART plasma levels of IL-7 and IL-15, cytokines regulating T-cell homeostasis. Notably, pre-ART PD-1 and TIGIT expression levels were higher in blood CM and TM CD4 T-cells for ISR; this was associated with a significantly lower fold-changes in HIV-DNA levels between pre- and on-ART time points exclusively on CM and TM T-cell subsets, but not naïve or EM T-cells. Finally, the frequency of CM CD4 T-cells expressing PD-1 or TIGIT pre-ART as well as plasma levels of IL-7 and IL-15 predicted HIV-DNA content on-ART. Our results establish the association between infection, T-cell homeostasis, and expression of PD-1 and TIGIT in long-lived CD4 T-cell subsets prior to ART with CD4 T-cell recovery and HIV persistence on-ART.
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