Description
The results of the ANRS EP47 VISCONTI (Viro-Immunological Sustained COntrol after Treatment Interruption) study provided proof of concept that a state of sustainable HIV remission may be induced in at least some people with HIV: the post-treatment controllers (PTC). Unlike natural controllers, PTCs presented a symptomatic primary HIV-1 infection with high viral load and low CD4 T cell counts. Most of them do not carry protective HLA class I alleles, but rather neutral or high risk alleles (such as HLA-B*35 ) and have very weak CD8+ T cell responses. The levels of T cell activation are also higher in natural controllers than in PTC. Altogether, these parameters suggest that the mechanism of viral control observed in PTC, although remain elusive, are different from those reported in HIV controllers. The objectives of this study are twofold: i) To define correlates of protection that would identify potential PTC, and ii) To understand how time of treatment initiation shapes the viral reservoirs and immune responses and how this impacts the dynamics of viral rebound after stopped.
