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Lausanne University Hospital (CHUV): T Follicular Helper Cells – A Key to the Understanding of the Mechanisms of HIV Persistence

A study, published yesterday in Nature Medicine , has shown that T follicular helper (Tfh) cells serve as the dominant cell reservoir for HIV infection. The study was led by Professors Matthieu Perreau and Giuseppe Pantaleo from the Service of Immunology and Allergy, Lausanne University Hospital, Lausanne, Switzerland.

The researchers have investigated the HIV reservoir in aviremic individuals treated for several years (up to 14 years) with antiretroviral (ART) therapy. The study demonstrates that a population of CD4 T cells residing within the germinal centers of lymph nodes, known as Tfh cells, serves as the dominant cell reservoir for HIV infection. The Tfh cells which represent less than 1% of total CD4 T cells in long-term ART treated individuals, contained replication competent and infectious virus. Germinal centers are difficult to access to cytotoxic CD8 T cells and thus represent a privileged anatomic site, e.g. a sanctuary, for the persistence of HIV in Tfh cells in long-term ART treated individuals.

Despite the major advances in ART therapy and the effective suppression of HIV replication, ART is not capable of eliminating HIV. HIV invariably rebounds after ART interruption and therefore life-time ART therapy is currently required for controlling virus replication. The present study appeared in Nature Medicine shed light on a fundamental issue, i.e. the identification of the cells that may be responsible for the rapid rebound of virus replication following ART interruption.

“The identification of Tfh cells as the major cell compartment containing replication competent and infectious HIV represents a major advance in our understanding of the mechanisms of HIV persistence following many years of ART-mediated virus suppression”, says Prof. Matthieu Perreau.

“We are very excited of the identification of Tfh cells as the major cell reservoir for HIV in long-term treated individuals. These observations will promote the development of therapeutic immune-based interventions that can directly target the HIV cell reservoir and have substantial impact in accelerating research in the fields of HIV functional cure and eradication”, says Prof. Pantaleo.

Contact:

Lausanne University Hospital
Prof. Giuseppe Pantaleo
Giuseppe.Pantaleo@chuv.ch
or
Matthieu Perreau
Matthieu.Perreau@chuv.ch

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