Important note: Information in this article was accurate in October 2005. The state of the art may have changed since the publication date.
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AIDSWEEKLY Plus; Monday, October 24, 2005
Staff Medical Writers
According to a study from the Netherlands, "Long-term nonprogressive HIV infection, characterized by low but detectable viral load and stable CD4 counts in the absence of antiviral therapy, is observed in about 5% of HIV-infected patients.
"Here we identified four therapy naïve individuals who are strongly seropositive for HIV-1 but who lack evidence of detectable HIV p24 antigen, plasma RNA, and proviral DNA in routine diagnostic testing."
"With an ultrasensitive PCR, we established that frequencies of pol proviral DNA sequences were as low as 0.2-0.5 copies/106 PBMC. HIV could not be isolated using up to 30x106 patient PBMC," reported N. Kloosterboer and colleagues at the University of Amsterdam.
"One individual was heterozygous for CCR5 Delta 32, but CCR5 expression on CD4+ T cells was normal to high in all four individuals. In vitro R5 and X4 HIV-1 susceptibility of CD8-depleted PBMC of all study subjects was significantly lower than the susceptibility of CD8-depleted PBMC of healthy blood donors.
"All individuals expressed protective HLA-B*58s alleles and showed evidence of HIV-specific cellular immunity either by staining with HLA-B*57 tetramers folded with an HIV RT or gag peptide or after stimulation with HIV-1 p24 gag, RT, or nef peptides in ELIspot analysis," scientists said.
The authors continued, "HIV-specific CD4+ T helper cells were demonstrated by proliferation of CD4+ T cells and intracellular staining for IL-2 and IFN gamma after stimulation with an HIV-gag peptide pool. Sera of all individuals showed antibody-mediated neutralization of both R5 and X4 HIV-1 variants."
"These data implicate that very low-level antigen exposure is sufficient for sustained HIV-specific immunity and suggest the possibility of a multifactorial control of HIV infection," Kloosterboer concluded.
Kloosterboer and colleagues published the results of their research in Virology (Natural controlled HIV infection: Preserved HIV-specific immunity despite undetectable replication competent virus. Virology. 2005 Aug 15;339(1):70-80.
For additional information, contact H. Schuitemaker, University of Amsterdam, CLB, Sanquin Research, Plesmanlaan 125, NL-1066 CX Amsterdam, Netherlands.
The publisher of the journal Virology can be contacted at: Academic Press Inc. Elsevier Science, 525 B St., Ste. 1900, San Diego, CA 92101-4495, USA.
Keywords: CX Amsterdam, Netherlands, HIV/AIDS, Antigen Exposure, Virus-Specific Immunity, Viral Replication, CD4 Cells, Antiviral Therapy.
This article was prepared by AIDS Weekly editors from staff and other reports.
Reference
Kloosterboer N, Groeneveld PH, Jansen CA, et al. Natural controlled HIV infection: preserved HIV-specific immunity despite undetectable replication competent virus, Virology. 2005 Aug 15;339(1):70-80.
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