HIV Reservoir Ecology of Viral Remission

项目摘要 艾滋病毒领域的最高优先事项之一是寻求治疗干预措施， 抗逆转录病毒治疗（ART）-免费艾滋病毒缓解。虽然大多数艾滋病毒感染者会经历 ART中断后病毒迅速反弹，有罕见的个体，称为治疗后控制者（PTC）， 在治疗停止后数月或数年内表现出持续的病毒学抑制。这些 个人被认为是持久控制艾滋病毒的理想例子，对艾滋病毒治愈有直接影响 research.然而，我们对艾滋病毒缓解的病毒学决定因素的理解仍然不完整。这 部分原因是通过任何一个研究中心或临床试验确定的PTC稀缺，部分原因是 因为迄今为止进行的病毒储库研究范围有限。这个的主要目标 我们的建议是对PTC进行深入的病毒学分析，我们的首要假设是HIV 储库特征可以提供其实现HIV缓解的能力背后的机制见解。 通过一项国际努力，我们建立了抗逆转录病毒药物治疗后艾滋病毒的控制机制， （CHAMP）研究，全球最大的PTC研究。我们对来自CHAMP队列的PTC的初步研究 已经产生了有趣的发现，包括第一个HIV储库生物标志物的鉴定，总前病毒 基因组数量，预测哪些个体将在治疗中断后成为PTC。虽然这些 结果是有希望的，艾滋病病毒的水库是远远更复杂的不仅仅是总数的前病毒基因组中， 外周血单个核细胞（PBMC）。艾滋病毒储存库的活动和影响必须考虑到 在我们称之为“艾滋病毒储存库生态学”的概念框架中考虑了一系列因素。这 该范例结合了有助于HIV持久性的组合前病毒、细胞和分子回路， 包括：1）前病毒准种的多样性：2）在细胞亚群和组织区室中的分布; 3)转录调控;和4）宿主中HIV整合位点的染色体环境 基因组使用在实验室中开发的新的检测方法，我们建议采取一项 在PTC和非控制者（NC）中表征HIV水库生态的整体方法。的 这些研究的结果将促进我们对PTC中HIV控制机制的理解， 预测治疗后控制和确定这些电路中哪一个可能是最好的影响 在为所有艾滋病毒感染者设计艾滋病毒缓解战略时，

PROJECT SUMMARY Among the top priorities of the HIV field is the search for therapeutic interventions that can lead to sustained antiretroviral therapy (ART)-free HIV remission. Although the majority of HIV-infected persons will experience rapid viral rebound after ART interruption, there are rare individuals, termed post-treatment controllers (PTCs), who demonstrate sustained virologic suppression for months or years after treatment cessation. These individuals are considered an ideal example of durable HIV control, with direct implications for HIV cure research. However, our understanding of the virologic determinants of HIV remission remains incomplete. This is in part due to the scarcity of PTCs identified through any one research center or clinical trial, and in part because of the limited scope of viral reservoir studies that have been performed to date. The main goal of this proposal is to perform an in-depth virologic analysis of PTCs and our overarching hypotheses are that HIV reservoir characteristics can provide mechanistic insights behind their ability to achieve HIV remission. Through an international effort, we have established the Control of HIV after Antiretroviral Medication Pause (CHAMP) study, the largest study of PTCs world-wide. Our initial studies of PTCs from the CHAMP cohort has already yielded intriguing findings, including the identification of the first HIV reservoir biomarker, total proviral genome numbers, that predicts which individuals will become PTCs after treatment interruption. While these results are promising, the HIV reservoir is far more complex than just the total number of proviral genomes in the peripheral blood mononuclear cells (PBMCs). The activity and impact of the HIV reservoir must take into account a constellation of factors in a conceptual framework that we call the “HIV reservoir ecology”. This paradigm incorporates the combined proviral, cellular and molecular circuits that contribute to HIV persistence, including: 1) diversity of proviral quasispecies; 2) distribution within cellular subsets and tissue compartments; 3) transcriptional regulation; and 4) the chromosomal environment of the HIV integration sites in the host genome. Using novel assays developed in the laboratories of the proposing investigators, we propose to take a holistic approach in characterizing the HIV reservoir ecology in both PTCs and non-controllers (NCs). The results of such studies will advance our understanding of the mechanisms of HIV control in PTCs, with implications for predicting post-treatment control and determining which of these circuits may be the best targets in the design of HIV remission strategies for all individuals living with HIV.