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Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0b013e3283454058
Elite controllers: Edited by Steven G. Deeks, Alexandre Harari and Joel Blankson

HIV-specific CD4 T cells and immune control of viral replication

Porichis, Filipposa; Kaufmann, Daniel Ea,b

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Purpose of review: To understand the role of HIV-specific CD4 T cells in viral control and highlight recent progress in the field.

Recent findings: HIV-specific CD4 T cells show higher functional avidity in elite controllers than in patients with progressive infection. There is an attrition of the HIV-specific CD4 T-cell population in the digestive mucosa of antiretroviral therapy (ART)-treated patients that contrasts with robust responses in individuals with spontaneous viral control. Secretion of the cytokine IL-21, by HIV-specific CD4 T cells, is associated with disease control and enhances the capacity of HIV-specific CD8 T cells to suppress viral replication. Studies of the PD-1, IL-10, and Tim-3 pathways provided insight into mechanisms of HIV-specific CD4 T-cell exhaustion and new evidence that manipulation of these networks may restore immune functions. Robust, polyfunctional CD4 T-cell responses can be elicited with novel HIV and simian immunodeficiency virus (SIV) vaccines.

Summary: These observations show that HIV-specific CD4 T-cell responses are different in elite controllers and individuals with progressive disease. Evidence suggests that HIV-specific CD4 T cells will be an important component of an effective HIV vaccine and significant efforts need to be made to further our understanding of HIV-specific CD4 T-cell functions in different body compartments.

© 2011 Lippincott Williams & Wilkins, Inc.


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