What Is the most Important for Elite Control: Genetic Background of Patient, Genetic Background of Partner, both or neither? Description of Complete Natural History within a Couple of MSM

作者：Bendenoun M; Samri A; Avettand Fenoel V^*; Cardinaud S; Descours B; Carcelain G; Mazeron M C; Bergmann J F; Urrutia A; Moris A; Rouzioux C; Simon F; Andre P; Pocard M; Dray X; Mourez T; Vieillard V; Autran B; Barin F; Sellier P^*

来源：EBioMedicine, 2018, 27: 51-60.

DOI：10.1016/j.ebiom.2017.12.003

• HIV-1
• Elite control
• Incomplete western blot
• HIV-1 DNA
• Immune activation
• HLA B*07C*07
• Partner

Background: We describe a homosexual man who strongly controlled HIV-1 for ten years despite lack of protective genetic background.
Methods: HIV-1 DNA was measured in blood and other tissues. Cell susceptibility was evaluated with various strains. HIV-1-specific (CD4 and CD8 activation markers and immune check points) and NK cells responses were assessed; KIRs haplotypes and HLA alleles were determined.
Findings: Two HIV-1 RNA copies/mL of plasma were detected in 2009, using an ultra-sensitive assay. HIV- DNA was detected at 1.1 and 2 copies/10(6) PBMCs in 2009 and 2015 respectively, at 1.2 copies/10(6) cells in rectal cells in 2011. WBs showedweak reactivity with antibodies to gp160, p55 and p25 from 2007 to 2014, remaining incomplete in 2017 Delta CD4 T cellswere susceptible to various strains including HIVKON, a primary isolate of his own CRF02_AG variant. CD8 T cells showed a strong poly-functional response against HIV-Gag, producingmainly IFN gamma; a robust capacity of antibody-dependant cell cytotoxicity (ADCC) was observed in NK cells. Case patient was group B KIR haplotype. Neutralizing antibodies were not detected. CD4 and CD8 blood T cells showed normal proportions without increased activation markers. Phylogenetic analyses identified the same CRF02_AG variant in his partner. The patient and his partner were heterozygous for the CCR5 Delta D32 deletion and shared HLA-B* 07, C*07 non-protective alleles.
Interpretation: This thorough description of the natural history of an individual controlling HIV- 1 in various compartments for ten years despite lack of protective alleles, and of his partner, may have implications for strategies to cure HIV-1 infection.

• 出版日期2018-1