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Slow progression of pediatric HIV associates with early CD8+ T cell PD-1 expression and a stem-like phenotype

Abstract:
HIV non-progression despite persistent viraemia is rare among antiretroviral therapy (ART)-naïve adults, but relatively common among ART-naïve children. Previous studies indicate that ART-naïve paediatric slow-progressors (PSPs) adopt immune evasion strategies similar to those described in the SIV natural hosts. However, the mechanisms underlying this immunophenotype are not well understood. In a cohort of early-treated infants who underwent analytical treatment interruption (ATI) after 12 months of ART, expression of PD-1 on CD8+ T-cells immediately prior to ATI was the main predictor of slow progression during ATI (r=0.77, p=0.002). PD-1+ CD8+ T-cell frequency was also negatively correlated with CCR5 (r=-0.74, p=0.005) and HLA-DR (r=-0.63, p=0.02) expression on CD4+ T-cells and predicted stronger HIV-specific T-lymphocyte responses. In the CD8+ T-cell compartment of PSPs, we identified an enrichment of stem-like TCF-1+PD-1+ memory cells, whereas paediatric progressors and viraemic adults were populated with a terminally exhausted PD-1+CD39+ population. TCF-1+PD-1+ expression on CD8+ T-cells was associated with higher proliferative activity (r=0.41, p=0.03) and stronger Gag-specific effector functionality. These data prompt the hypothesis that the proliferative burst potential of stem-like HIV-specific cytotoxic cells could be exploited in therapeutic strategies to boost the antiviral response and facilitate remission in early-ART-treated infants with a preserved and non-exhausted T-cell compartment
Publication status:
Published
Peer review status:
Peer reviewed

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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0001-9261-7726
More by this author
Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-5271-7295


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Funder identifier:
10.13039/100010269
Grant:
WT104748MA
More from this funder
Funder identifier:
10.13039/100000098
Grant:
RO1-AI133673


Publisher:
American Society for Clinical Investigation
Journal:
JCI Insight More from this journal
Volume:
8
Issue:
3
Pages:
e156049
Article number:
e156049
Publication date:
2023-02-08
DOI:
EISSN:
2379-3708
ISSN:
2379-3708


Language:
English
Keywords:
Pubs id:
1318614
Local pid:
pubs:1318614
Source identifiers:
W4313546182
Deposit date:
2026-05-01
ARK identifier:
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