Characterization of HIV reservoirs to prepare future therapeutic trials aimed at remission

Despite the effectiveness of current antiretroviral treatments, the persistence of the Human Immunodeficiency Virus (HIV) genome in reservoir cells is the major obstacle to eradicating the virus. Véronique Avettand-Fenoel's group works on characterizing the reservoirs of HIV and its simian counterpart, SIV, at the molecular, cellular and tissue levels, from pathogenesis to clinical studies.
In particular, this group has characterized the contribution of different forms of HIV DNA and the dynamics of the archived viral quasispecies at various clinical stages (Trémeaux et al. 2019, Avettand-Fenoel et al. 2019, Hocqueloux et al. 2019, Avettand-Fenoel et al 2021, Trémeaux et al. 2023).
Véronique Avettand-Fenoel is responsible for virological follow-up of several national ANRS MIE cohorts of people living with HIV (PRIMO cohort, CODEX cohort: natural controls without antiretroviral treatment; and post-treatment controls = VISCONTI = in remission). The group is involved in a number of national and European studies and clinical trials, notably developed within the RHIVIERA consortium, aimed either at characterizing HIV reservoirs in infected individuals and animal models, or at targeting these reservoirs.
(i) One of the objectives is to determine the mapping of tissue reservoirs in humans, in relation to the pharmacokinetic parameters of antiretroviral diffusion in the various compartments.
(ii) Another aim developed in the P-VISCONTI study (an experimental macaque model of post-treatment control) is to explore a wide range of tissues, using phylodynamic approaches; to investigate the potential contribution of viral factors to infection control after treatment interruption; and to look for factors predictive of remission.
(iii) These two points will also be studied in humans in two contexts. The first concerns people treated since primary infection and carrying a specific HLA genotype, which may be linked to an effective NK response (ANRS RHIVIERA 01 trial). The second involves participants in a trial evaluating the combination of antiretroviral therapy and broadly neutralizing antibodies since primary infection (ANRS RHIVIERA02 trial).
(iv) Finally, the group will explore HIV reservoirs in children and adolescents infected through mother-to-child transmission (ANRS CLEAC study - French context, and ANRS PEDIACAM study - Cameroon). These individuals may also be good candidates for remission trials when they have received early treatment.

The overall aim of these various studies is to better characterize HIV reservoirs and identify biomarkers predictive of remission, in preparation for future trials targeting these reservoirs to achieve HIV remission/eradication without antiretroviral treatment.