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No evidence that circulating HIV-specific immune responses contribute to persistent inflammation and immune activation in persons on long-term ART.


ABSTRACT:

Objective

People with HIV (PWH) have persistently elevated levels of inflammation and immune activation despite suppressive antiretroviral therapy (ART), with specific biomarkers showing associations with non-AIDS-defining morbidities and mortality. We investigated the potential role of the HIV-specific adaptive immune response, which also persists under ART, in driving levels of these clinically relevant biomarkers.

Design

Cohort-based study.

Methods

HIV-specific IFN-γ-producing T-cell responses and antibody concentrations were measured in blood at study entry in the ACTG A5321 cohort, following a median of 7 years of suppressive ART. HIV persistence measures including cell-associated (CA)-DNA, CA-RNA, and plasma HIV RNA (single-copy assay) were also assessed at study entry. Plasma inflammatory biomarkers and T-cell activation and cycling were measured at a pre-ART time point and at study entry.

Results

Neither the magnitudes of HIV-specific T-cell responses nor HIV antibody levels were correlated with levels of the inflammatory or immune activation biomarkers, including hs-CRP, IL-6, neopterin, sCD14, sCD163, TNF-α, %CD38 + HLA-DR + CD8 + and CD4 + cells, and %Ki67 + CD8 + and CD4 + cells - including after adjustment for pre-ART biomarker level. Plasma HIV RNA levels were modestly correlated with CD8 + T-cell activation ( r  = 0.25, P  = 0.027), but other HIV persistence parameters were not associated with these biomarkers. In mediation analysis, relationships between HIV persistence parameters and inflammatory biomarkers were not influenced by either HIV-specific T-cell responses or antibody levels.

Conclusion

Adaptive HIV-specific immune responses do not appear to contribute to the elevated inflammatory and immune activation profile in persons on long-term ART.

SUBMITTER: Ward AR 

PROVIDER: S-EPMC9444951 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

No evidence that circulating HIV-specific immune responses contribute to persistent inflammation and immune activation in persons on long-term ART.

Ward Adam R AR   Thomas Allison S AS   Stevenson Eva M EM   Huang Szu-Han SH   Keating Sheila M SM   Gandhi Rajesh T RT   McMahon Deborah K DK   Bosch Ronald J RJ   Macatangay Bernard J BJ   Cyktor Joshua C JC   Eron Joseph J JJ   Mellors John W JW   Jones R Brad RB  

AIDS (London, England) 20220622 12


<h4>Objective</h4>People with HIV (PWH) have persistently elevated levels of inflammation and immune activation despite suppressive antiretroviral therapy (ART), with specific biomarkers showing associations with non-AIDS-defining morbidities and mortality. We investigated the potential role of the HIV-specific adaptive immune response, which also persists under ART, in driving levels of these clinically relevant biomarkers.<h4>Design</h4>Cohort-based study.<h4>Methods</h4>HIV-specific IFN-γ-pro  ...[more]

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