Longitudinal evaluation of reservoir size decay in naive HIV patients starting ART

Alessia Bertoldi

Despite the suppression of its active replication, HIV is able to integrate and persist in long-lived latently infected CD4+ T cells producing infectious particles following T cell stimulation. The presence of resting CD4+ T cells harbouring a transcriptionally silent, yet replication-competent, provirus represents a major barrier to eradication. In this study treatment-naŃ—ve patients will be enrolled and divided in two different groups based on the specific therapy regimen they will receive: backbone plus either an integrase inhibitor or a protease inhibitor. Quantifying the amount of latently infected cells is critical to evaluate the efficacy of available regimens against cellular reservoirs; however, the extremely low frequency of these cells makes this very challenging. We will use two different methods to measure the size of the reservoir: a) a novel assay that measures the frequency of cells harbouring replication-competent virus, TILDA; b) the quantification of total and integrated viral DNA. We expect to see a faster decay of reservoir in patients treated with integrase inhibitors, as these drugs prevent viral integration. So far, we managed to set up TILDA protocol and modify it in order to detect not only the B, but also C subtype.

Simone Agnello
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