Residual Replication of HIV-1 in the Gut Associated Lymphoid Tissue (GALT) of Patients on Highly Active Antiretroviral Therapy (HAART): the ANRS EP 44 Study (EP 44)

Residual Replication of HIV-1 in the Gut Associated Lymphoid Tissue (GALT) of Patients on Highly Active Antiretroviral Therapy (HAART): the ANRS EP 44 Study

Characterization of the Residual Replication of HIV-1 in the Gut-associated Lymphoid Tissue in Patients Receiving Effective Highly Active Antiretroviral Therapy: the ANRS EP 44 Study

HIV-1 cannot be eradicated from infected individuals by current antiretroviral regimens. Cellular reservoirs and tissue sanctuary sites allow latent HIV-1 persistence and ongoing low-level virus replication. This project aims to characterize the residual replication of HIV-1 in subjects on antiretroviral therapy, particularly in the gut-associated lymphoid tissue.

Highly active antiretroviral therapy (HAART) successfully controls HIV-1 replication in most individuals, resulting in substantial immune restoration and decreased morbidity and mortality. However HIV-1 cannot be eradicated from infected individuals by current regimens. Cellular reservoirs and tissue sanctuary sites allow latent HIV-1 persistence and ongoing low-level virus replication, despite maximum virus suppression on HAART. This project aims to characterize the residual replication of HIV-1 in subjects on HAART, particularly in the gut-associated lymphoid tissue (GALT). A group of 20 HIV-1-infected patients on effective HAART will undergo GI endoscopy and GALT biopsies will be taken. A sample of venous blood will also be collected. These samples will be use to characterize the residual viral populations on effective HAART in three compartments, plasma, monocytes, and GALT. HIV-1 coreceptor usage and its evolution on HAART will be characterized in virus reservoirs. This project could provide further insights into the residual replication of HIV-1 in subjects receiving HAART.

HIV infection, HAART, Viral DNA test positive-10063306, Blood HIV RNA 10049826, Treatment Experienced

This project aims to characterize the residual replication of HIV-1 in subjects on HAART, particularly in the gut-associated lymphoid tissue (GALT)

These samples of blood will be use to characterize the residual viral populations on effective HAART in three compartments, plasma, monocytes, and GALT

Inclusion Criteria: HIV-1 infection (ELISA and western-blot tests) Continuous antiretroviral therapy >= 12 months Plasma HIV-1 RNA =< 40 copies/ml >= 6 months Indication of gastro-intestinal endoscopy Age >= 18-year old Physical examination Informed consent Exclusion Criteria: Plasma HIV-1 RNA > 40 copies/ml in the last 6 months Involvement in a HIV vaccine study Treatment with interferon-alpha or PEG- interferon-alpha in the last 6 months Treatment with interleukin-2 in the last 6 months Decompensated cirrhosis Abnormal hemostasis tests Inflammatory bowel disease ; coeliac disease Lymphoma Blood transfusion in the last 6 months Absence of social security (health insurance) Pregnant or breastfeeding woman Incapable adult