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Can interruption/withdrawl of anti‐retroviral therapy provide personalized immunotherapy against HIV‐1?
Author(s) -
Bretscher Peter A.,
AlYassin Ghassan
Publication year - 2020
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12934
Subject(s) - immunotherapy , medicine , immunology , immunity , antibody , immune system , virus , virology , cytotoxic t cell , viral load , human immunodeficiency virus (hiv) , biology , biochemistry , in vitro
We propose a treatment of HIV‐1 + individuals designed to harness protective immunity, lead to viral containment, and so render the individual minimally infectious. A few HIV‐infected individuals, ‘elite controllers’, generate a stable Th1, cytotoxic T lymphocyte response that contains the virus. Most infected individuals, in the absence of therapy, first generate a similarly protective response that evolves with time a Th2 component, associated with antibody production and loss of viral control. Cessation of anti‐retroviral treatment after three years results in viral rebound in most, but about one in seven individuals contains the virus, so‐called post‐treatment controllers. We suggest an understanding, of how the Th1/Th2 phenotype of immune responses is controlled, can explain these different outcomes and leads us to propose a non‐invasive, personalized strategy of immunotherapy. We propose that monitoring the relative prevalence of HIV‐1 specific IgG 1 and IgG 2 antibodies can provide a biomarker for deciding when to interrupt/withdraw anti‐retroviral therapy to optimally harness protective immunity.