# Project 1. Defining Virologic and Immunologic Factors Predicting the Probability of Post-Treatment HIV Control

> **NIH NIH P01** · BOSTON COLLEGE · 2021 · $139,094

## Abstract

ABSTRACT
Antiretroviral therapy blocks HIV replication, but is not curative, as quiescent integrated HIV DNA is not
eradicated by classical drugs. HIV reservoirs of latently infected cells persist indefinitely in infected patients
even after long-term periods of treatment and cause rapid viral rebound if the treatment is stopped. Our
identification of some patients who were able to durably control viremia after therapy discontinuation (Post-
Treatment Controllers, PTCs) introduced the concept of sustained HIV remission and provided proof of
concept that such status is achievable at least in some patients. HIV remission in PTCs is characterized by the
presence of infected cells, although at low levels. This implies that this situation of long-term viral control
requires balanced interactions between HIV-1 and the host. Yet, intriguingly, PTCs do not have the genetic,
clinical or immunological characteristics that are commonly found in the rare patients able to naturally control
HIV-1 without therapeutic intervention (HIV controllers). HIV remission appears to be favored by the early
initiation of antiretroviral treatment and its maintenance for several years before discontinuation. We believe
that PTCs benefited from an early treatment that limited the establishment of viral reservoirs and allowed
optimal maturation/priming and preservation of critical immune responses. However, only a small fraction of
early and durably treated patients are able to control infection after treatment interruption. There is therefore an
urgent need to identify the precise mechanisms associated with post-treatment control of infection and define
biomarkers that predict the outcome of cART discontinuation. For this, it will be essential to better understand
(i) the dynamics of the establishment and maintenance of cellular HIV reservoirs, (ii) the interplay between
immune responses and infected cells, and (iii) the impact of early cART on these parameters.
We will compare immunological and virological parameters in PTCs and in patients on effective long-term
cART, initiated during primary or chronic HIV-infection. We will use empirical analyses and mathematical
modeling to (i) define correlates of protection that could identify ART-receiving patients with the highest
probability to achieve HIV remission; and (ii) provide a detailed characterization of the effect of treatment
initiation on the pattern and the size of the viral reservoirs and immune responses and how this impact the
dynamics of viral rebound at the time of treatment initiation. To develop this project we will benefit of access to
unique samples from patients in ANRS PRIMO and ANRS VISCONTI Cohorts and to the empirical data
generated in a large non-human primate study of 66 SIV-infected macaques initiating cART at different times
and maintaining the treatment for 2 years before interruption.

## Key facts

- **NIH application ID:** 10246901
- **Project number:** 7P01AI131365-05
- **Recipient organization:** BOSTON COLLEGE
- **Principal Investigator:** Asier Saez-Cirion
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $139,094
- **Award type:** 7
- **Project period:** 2017-08-11 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246901

## Citation

> US National Institutes of Health, RePORTER application 10246901, Project 1. Defining Virologic and Immunologic Factors Predicting the Probability of Post-Treatment HIV Control (7P01AI131365-05). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10246901. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*