Conférence scientifique | Centre de recherche du CHU Sainte-Justine
Conférencier:
Nicolas Chomont, PhD
- Professeur agrégé sous octroi, Département de microbiologie, infectiologie et immunologie, Université de Montréal
- Chercheur régulier, Centre de recherche du CHUM
Résumé:
Advances in the treatment of HIV infection have dramatically reduced the death rate from AIDS and improved the quality of life of many people living with HIV. Although lifelong suppression of HIV replication with antiretroviral therapy (ART) seems possible, side effects, resistance, stigma and cost all contribute to the necessity of finding a cure. It is now clear that ART alone does not eradicate HIV: Even after more than 15 years of intensive and continuous therapy, the spread of the virus resumes within a few weeks upon cessation of ART in all but exceptional cases.
The failure to cure HIV infection is believed to result from low-level viral production/replication, the presence of latent replication-competent provirus in resting CD4+ T cells, and T-cell dysfunction stemming from persistent immune activation. Current ART does not target the reservoir of long-lived latently infected cells and does not fully restore immune functions. Insights into cellular mechanisms that control HIV gene expression and chronic immune activation suggest that the modulation of immune functions may accomplish both of these goals. Several immunologic strategies aimed at curing HIV infection are currently being investigated and will be presented. They include (i) the initiation of ART during the first few weeks of infection to preserve immune functions and prevent the establishment of a long-lived reservoir for HIV; (ii) immune checkpoint blockade to revert HIV latency and boost antiviral T cell responses and (iii) T cell homeostasis modulation to shorten the lifespan of infected cells. Combining immunological and virological approaches will be essential to significantly reduce the size of the latent HIV reservoir.
