Correlating HIV tropism with immunological response under combination antiretroviral therapy

Bader, J; Schöni-Affolter, F; Böni, J; Gorgievski, Meri; Martinetti, G; Battegay, M; Klimkait, T; Swiss HIV Cohort, Study (2016). Correlating HIV tropism with immunological response under combination antiretroviral therapy. HIV medicine, 17(8), pp. 615-622. Blackwell Science 10.1111/hiv.12365

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OBJECTIVES

A significant percentage of patients infected with HIV-1 experience only suboptimal CD4 cell recovery while treated with combination therapy (cART). It is still unclear whether viral properties such as cell tropism play a major role in this incomplete immune response. This study therefore intended to follow the tropism evolution of the HIV-1 envelope during periods of suppressive cART.

METHODS

Viruses from two distinct patient groups, one with good and another one with poor CD4 recovery after 5 years of suppressive cART, were genotypically analysed for viral tropism at baseline and at the end of the study period.

RESULTS

Patients with CCR5-tropic CC-motif chemokine receptor 5 viruses at baseline tended to maintain this tropism to the study end. Patients who had a CXCR4-tropic CXC-motif chemokine receptor 4 virus at baseline were overrepresented in the poor CD4 recovery group. Overall, however, the majority of patients presented with CCR5-tropic viruses at follow-up.

CONCLUSIONS

Our data lend support to the hypothesis that tropism determination can be used as a parameter for disease progression even if analysed long before the establishment of a poorer immune response. Moreover, the lasting predominating CCR5-tropism during periods of full viral control suggests the involvement of cellular mechanisms that preferentially reduce CXCR4-tropic viruses during cART.

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