New Insights in the Immune Control of HIV-1 Infection
Alexandre Harari 1, Giuseppe Pantaleo 1
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*Correspondence: Alexandre Harari, Email not available
Abstract
Major advances have been made in recent years on the characterization of HIV-specific immune responses and in particular on the correlates of protective immunity. HIV-1-specific CD4 helper T cells are selectively lost or severely reduced in number already at the time of primary infection while CD4 helper T cells specific for other viruses such as CMV are not impaired. There is a vigorous HIV-1- specific CD8 T cell response. However, there are qualitative abnormalities in the composition of the memory CD8 T cells with a poor proportion of terminally differentiated HIV-1-specific memory CD8 T cells. This may translate in a different ability to control virus replication since memory CD8 T cells at earlier stages of differentiation have lower levels of perforin expression and reduced lytic capacity. These immunologic defects are not restored by prolonged antiviral treatment in patients with chronic infection. Therefore, it is necessary to complement antiviral therapy with immune-based interventions in order to restore an effective antiviral immune response capable of maintaining long-term control of HIV-1 replication and disease.
