Natural Killer Cells as Effectors in HIV Cure Strategies

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Antiretroviral therapy (ART) has resulted in the life expectancy of HIV infected individuals no longer being significantly less than uninfected people. However, ART must be taken daily, has side effects and comes with significant financial costs. This has placed renewed emphasis on curing HIV. The barrier to a cure is a population of infected cells termed the reservoir, that remain invisible to both therapy and the immune system. Recent studies have shown that patients treated early in the course of HIV infection have lower viral reservoirs, and some can control viral replication after stopping ART for long periods of time. This is termed 'post treatment control' (PTC), and is a form of remission from HIV infection. If we understand it, PTC may help us find a cure for HIV. As of yet, we cannot predict which patients will and will not become post-treatment controllers. Some data suggests that a type of immune cell - called a Natural Killer (or 'NK') cell - might play an important role in this phenomenon.In this study, we will use two large cohorts of HIV infected patients who started ART early in infection (called SPARTAC and HEATHER) to determine if characteristics of NK cells can affect reservoir size, how to predict patients who will control viral replication off therapy, and find out how early ART will affect NK cell function. If we can find out how NK cells may help induce control of the virus, such that treatment can be stopped for a while, this will help us plan new treatments as we search for a cure for HIV infection.