HIV immunotherapy comes of age: implications for prevention, treatment and cure

ABSTRACT

Antiretroviral therapy (ART) has reshaped the lives of millions of individuals infected with human immunodeficiency virus (HIV). Patients initiating ART early in the course of infection benefit from a considerable reduction in the risks of acquired immune deficiency syndrome (AIDS) and HIV-related inflammatory events. However, the absence of cure and lifelong requirements of treatment highlight the need of a vaccine and an immunotherapeutic strategy. Like for cancer, a paradigm shift has occurred with the contribution of immune activation and microbial translocation priming aberrant systemic immunity in restricting the ability of the host to mount an effective immune response. The approaches of implementing an effective vaccine to prevent infection and inhibition of immune activation with breakage of viral latency followed by vaccination should lead to an HIV-free generation.

KEYWORDS:

• HIV vaccine
• immunotherapy
• T-cell exhaustion
• immune activation
• interleukin 7
• interleukin 21
• dendritic cell vaccine
• immunometabolism
• microbial translocation

Financial & competing interests disclosure

This work was supported by the Fonds de Recherche du Québec - Santé (FRQ-S): Therapie cellulaire and Reseau SIDA/Maladies infectieuses, Canadian Institutes of Health Research (grants MOP 103230 and CTN 257), the Canadian Foundation for AIDS Research (CANFAR; grant 023-512), and the Canadian HIV Cure Enterprise Team Grant HIG-133050 from the CIHR in partnership with CANFAR. JP Routy is the holder of Louis Lowenstein Chair in Hematology & Oncology, McGill University. JP Routy received consulting fees and honoraria from ViiV, GSK, Merck Frosst, Abbvie, and BMS. V Mehraj is supported by a FRQ-S postdoctoral fellowship award. W Cao is supported by a CIHR/CTN International postdoctoral fellowship award. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Acknowledgement

The authors would like to thank Angie Massicotte, Research Institute of McGill University Centre, for her coordination and assistance with the manuscript.