HIV 'hides' in the body from the onset of infection | AIDS: on the trail of a pandemic

3d illustration of HIV

From the first days of infection, HIV constitutes “reservoirs” where it will hide, preventing triple therapies from completely eradicating it, a Montreal research team has shown for the first time. .

This discovery makes it possible to better understand when and how the virus constitutes these reservoirs which ensure its survival.

The team of researcher Nicholas Chomont, from the Center de recherche du CHUM, revealed that a small fraction of the virus integrates into the CD4+ T cell genome during the acute phase of infection, i.e. within the first few weeks.

The virus does not replicate inside these lymphocytes, which are responsible for activating the human body's defense against infection, allowing it to escape detection.

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This is the first time that this phenomenon has been measured in humans. It has so far only been seen in animal models of the disease.

This finding, Chomont said, is important in trying to understand how we can try to block this phenomenon.

If we better identify the cells that HIV infects at the very beginning, this could lead to the development of treatments to limit the spread of the virus, i.e. to further improve triple therapies by making them more effective from the beginning, Mr. Chomont said. It can also help us better understand how these reservoirs become established and therefore prevent their establishment.

Researchers found that during the first seven days of infection, the number of virus-infected CD4+ T cells increases from 10 to 1000 cells per million CD4+ T cells, indicating the extremely rapid spread of HIV .

Scientists have known for some time that cells of the immune system are the primary target of HIV. These cells are not all the same, however, and this is where their work had some surprises in store for them.

Cells called follicle cells, which are found in the lymph nodes and are a major contributor to HIV replication, were previously thought to be among the earliest targets of the virus.

The triple therapies currently available, he adds, are so effective that they can destroy 99.9% of the virus in the body, to the point where the life expectancy of people infected with the HIV is virtually identical to that of healthy people.

These reservoirs where the virus hides waiting to be given the chance to return are truly the last hurdle that remains to be overcome in order to defeat the disease, whether by attacking and destroying the virus in its hiding place, or even by simply preventing it from hiding somewhere at the start of the infection.

The aim of triple therapies is not to x27;to prevent the virus from falling asleep is to prevent it from replicating, Chomont said.

Some molecules currently available could prevent the virus from going into hiding, but they would have to be administered from the start of the infection to measure their effectiveness. This obviously implies very rapid screening of new patients, which is really a political and financial question, said the researcher.

In the meantime, the glimmers of hope for HIV patients are numerous. In addition to the work done by M. Chomont and others, the scientific literature has recently documented a third patient who was cured of his infection after a bone marrow transplant.

If such an intervention is simply not possible to treat everyone, we also know that two women got rid of the virus on their own, recalled Mr. Chomont.

It opens up really interesting new avenues of research because the body was not thought to be able to get rid of it on its own, he said.

< p class="e-p">The findings of this study were published by the medical journal Immunity (in English).