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CD8+ T cell recall cytotoxicity during chronic treated HIV-1 infection is associated with limited reservoir size and activity

ABSTRACT: The combination of replication-competent HIV-1 proviral persistence and virus-specific immune dysfunction prevents virus clearance during antiretroviral therapy (ART), resulting in rebound viremia after treatment interruption. Functional impairment of HIV-specific CD8+ T cells during chronic infection is typically not reversed by ART but has recently been shown to improve in some individuals after prolonged treatment. To evaluate the impact of cellular immune function on viral persistence, we mapped and functionally characterized HIV-1 epitope-specific CD8+ T cell responses and virus reservoirs in sixty people with HIV-1 (PWH) who initiated prolonged ART during chronic progressive infection. In 17% of participants, recall cytotoxicity of proliferative CD8+ T cells targeting one or more autologous proviral epitopes was comparable to responses in spontaneous HIV-1 controllers. These responses were associated with smaller and less transcriptionally active HIV-1 reservoirs during prolonged ART. Treatment interruption in one participant with moderately high HIV-specific CD8+ T cell proliferative and cytolytic capacity resulted in a rapid reduction of rebound viremia coincident with in vivo HIV-specific CD8+ T cell expansion and secondary cytotoxic effector cell differentiation. Collectively, these results highlight a potential role for recall cytotoxicity in limiting HIV-1 persistence during ART and attenuating rebound viremia after treatment interruption, which may inform strategies to elicit durable post-ART immune control.

ORGANISM(S): Homo sapiens

PROVIDER: GSE294427 | GEO | 2025/10/10

REPOSITORIES: GEO

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			Action	DRS
		Other
	GSE294427_HEAL_FILTERED_ADT_COUNTS.tsv.gz	Tabular
	GSE294427_HEAL_FILTERED_HTO_COUNTS.tsv.gz	Tabular
	GSE294427_HEAL_FILTERED_METADATA.tsv.gz	Tabular
	GSE294427_HEAL_FILTERED_RNA_COUNTS.tsv.gz	Tabular

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Project description:Therapeutic strategies that enhance anti-viral immunity and reduce the viral reservoir are critical to achieving durable remission of HIV. The co-inhibitory receptor programmed death-1 (PD-1) regulates CD8+ T cell dysfunction during chronic HIV and SIV infections 1-4. In addition, PD-1+ CD4+ T cells constitute a significant fraction of the HIV/SIV viral reservoir5-7. We previously demonstrated that in vivo blockade of PD-1 during chronic SIV infection improves the function of anti-viral CD8+ T cells and B cells 4,8. However, the immunological effects of PD-1 blockade during anti-retroviral therapy (ART) and the potential to destabilize the persistent HIV/SIV reservoir have not been studied. Here, we show that administration of anti-PD-1 antibody (PD-1 Ab) 10 days prior to initiation of ART rapidly enhanced anti-viral CD8+ T cell function and diminished interferon stimulated genes (ISGs) that resulted in markedly improved viral suppression in plasma and better Th17 cell reconstitution in the rectal mucosa following ART initiation. In addition, PD-1 blockade during suppressive ART resulted in transient increases in plasma viremia, induction of gene signatures associated with effector CD8+ T cell function and ISGs, and lower levels of cell associated replication-competent virus suggesting destabilization of the viral reservoir. Following ART interruption, PD-1 Ab treated animals showed markedly higher expansion of proliferating CXCR5+ Perforin+ Granzyme B+ effector CD8+ T cells and lower regulatory T cells that resulted in delayed viral rebound and better control of viremia. PD-1 blockade administered only during suppressive ART however was only partially effective. Our results indicate an optimal regimen of PD-1 blockade administered in combination with ART, that augments anti-viral CD8+ T cell function and reduces the viral reservoir leading to improved control of viral rebound after ART interruption. These results have important implications for developing novel therapeutic interventions to achieve durable remission of HIV.

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CD8+ T cell recall cytotoxicity during chronic treated HIV-1 infection is associated with limited reservoir size and activity

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