Genetic Factors Associated with Long-Term HIV Remission After Treatment Cessation

Recent research has shed light on the genetic traits that may enable some individuals to maintain undetectable HIV levels even after discontinuing antiretroviral therapy. Known as "post-treatment controllers," these individuals can sustain virological remission for years, with some controlling the virus for over 25 years without ongoing treatment. This phenomenon highlights the importance of immune system factors, particularly genetic characteristics linked to innate immunity cells like natural killer (NK) cells.

A collaborative study by the Pasteur Institute, Inserm, and the Paris Public Hospital Network analyzed individuals from the VISCONTI cohort and other sources to identify genetic markers associated with HIV control. The research found that certain immunogenetic traits, especially those involving HLA-B∗35 alleles, are overrepresented among post-treatment controllers. These genetic factors correlate with the presence of specific NK cell populations that are more effective at controlling HIV infection.

The study’s analysis of over 1,600 participants in the ANRS CO6 PRIMO cohort further confirmed that these genetic markers help encourage long-term remission, especially in individuals who started treatment early after infection. The immune response driven by these genetic traits appears to facilitate sustained viral suppression even after stopping therapy.

Scientists believe that understanding these genetic and immune mechanisms can pave the way for novel immunotherapies aimed at mobilizing NK cells or mimicking their activity. An ongoing clinical trial, called ANRS 175 RHIVIERA01, launched in March 2023, aims to explore the relationship between genetic markers of NK cells and post-treatment control by closely monitoring individuals with these genetic traits who discontinue treatment.

This discovery holds great promise for developing new strategies to achieve HIV remission or cure, reducing the need for lifelong medication. As Dr. Sáez-Cirión from the Pasteur Institute emphasizes, harnessing the immune system’s innate capacity could represent a significant breakthrough in HIV management, particularly in the face of challenges to universal access to antiretroviral therapy.

Source: MedicalXpress