Établissement et persistance du réservoir du VIH chez des individus traités très tôt en phase aigüe de l’infection (cohorte RV254)
Antiretroviral therapies (ART) have largely increased the life expectancy of the HIV infected individuals who have access to it. Nonetheless, these therapies can’t eradicate the virus that persist in a latent state in long-lived CD4+ T cells. These infected cells form a viral reservoir that remains the main obstacle to a cure.  Several studies have shown that initiation of ART during the acute infection can lead to a delay in the viral rebound or in some cases to viremia control after a treatment interruption. However, the timing and location of the establishment and persistence of the viral reservoir during acute infection remain unclear. Using, blood and lymphoid tissues samples from acutely infected participants, we observed that the virus is firstly integrated in lymph nodes and colon cells and reaches a maximum frequency of infected cells at the Fiebig stage II, i.e. before seroconversion in the tissues. Moreover, we saw that a very early initiation of ART results in a drastic decrease of the number of infected cells in all compartments. Nonetheless a few infected cells persist under ART in the lymph nodes.   Our results suggest that a large number of cells are infected early in tissues before moving into the blood during the acute infection. Nonetheless, these infected cells form a labile HIV reservoir which is rapidly, but incompletely, eliminated by an early initiation of ART.
Cellules T CD4+ mémoires HIV reservoir Acute infection Early treatment Lymphoid tissues Memory CD4+ T cells