Immunosenescence is the progressive loss of immune tissue that result from (i) functional, (ii) clonal or (iii) systemic changes to the cells or tissue that make up the immune system. While this process occurs gradually during the ageing process, there is overwhelming evidence to implicate HIV infection in driving all three aspects of immunosenescence by inducing high levels of immune activation. In the current literature, there is a dearth of data on the impact of HIV-2 infection or untreated perinatal HIV-1 infection in driving immunosenescence, and the key goal of this thesis is to mend this gap in knowledge. Both HIV-2 and paediatric HIV-1 infection provide excellent settings for verifying the mechanistic theories that relate to HIV-1-associated immunosenescence. The majority of HIV-2 infected individuals control their infection, which raises the question of how HIV-2 controllers are able to generate robust T-cell responses, when equivalent responses are rare in HIV-1 infected cohorts. Our hypothesis is that the former is an outcome of sustained or more robust homeostasis due to lower immune activation levels. Altogether, we show that primary immune resources are better preserved in HIV-2 than in HIV-1 infection - including more substantial HPC and naïve T-cell populations that correlate well with thymic output. The preservation of primary immune responses during HIV-2 infection is expected to contribute to robust effector functions and a younger phenotype of virus-specific memory T-cells. Accordingly, we show that HIV-2 specific memory T-cells reflect an earlier differentiated phenotype than HIV-1 specific T-cells, are highly polyfunctional and exhibit strong virus suppressive capabilities. In perinatally HIV-1 infected children - who by virtue of their age represent slow progressors - the presence of a hyperactive thymus may be sufficient to compensate against the early onset of immunosenescence and result in younger immune cell phenotypes. Yet, in measuring leucocyte telomere length and mtDNA content by qPCR, which qualify as biomarkers of senescence, we observed that leucocytes from vertically-infected Zimbabwean children present with shortened telomeres and an increase in mtDNA content, which signals the onset of advanced cellular senescence.

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No description available.

Throughout history, human populations have continuously been challenged by new and emerging infectious diseases. For the past 26 years, sub-Saharan Africa and other countries around the world have been dealing with a pandemic caused by a relatively new pathogen called the human immunodeficiency virus (HIV). Although antiretroviral (ARV) therapies effectively reduce morbidity and mortality rates, the long term use in those who have access to treatment inevitably leads to drug-related toxicity and resistance. Even with a strong commitment from governments to expand and finance prevention and treatment programs, transmission rates continue to outpace the benefits of these efforts. Therefore to effectively eradicate the disease, research is focusing on the design of protective and therapeutic vaccines. The first major step in designing these alternative therapies is to define correlates of immune protection. / The research presented in this thesis focuses on characterizing the quantitative and qualitative features of T cell immune responses in individuals who spontaneously control viral replication and exhibit a benign course of disease while remaining off ARV therapy. A comprehensive analysis of HIV-specific IFN-gamma secreting immune responses revealed that neither the breadth nor the magnitude of responses directed against the entire HIV proteome accurately predicts the viral load or rate of CD4 decline. Subsequent analyses showed that the preferential targeting of Gag was associated with reduced rates of CD4 decline and was later confirmed in a cohort of individuals in primary infection whereby the relative breadth and magnitude of Gag p24 was inversely correlated with viral load set point. / The maintenance of polyfunctional immune responses in HIV-infected subjects with a benign course of disease prompted us to develop a method that could comprehensively assess the breadth, magnitude and specificity of three functionally distinct subsets of HIV-specific lymphocytes (single IFN-gamma, single IL-2 and dual IFN-gamma/IL-2 secretors). Survey of immune responses in chronically infected individuals revealed that only the breadth and magnitude of dual IFN-gamma/IL-2 secreting lymphocytes correlated with reduced viral loads and increased CD4 counts suggesting that secretion of IFN-gamma alone was a poor correlate of protection. We also showed that the contribution of polyfunctional lymphocytes to the total response was greater for epitopes restricted by major histocompatibility complex (MHC) class I alleles associated with slow disease progression compared to those restricted by alleles associated with rapid or neutral rates of HIV disease progression. / Taken together, this work supports the view that immune monitoring of infected and vaccinated individuals should include methodologies capable of detecting both IFN-gamma and IL-2 secretion from responding T lymphocytes. The studies presented here have furthered our understanding of what constitutes protection from disease progression emphasizing that both specificity and polyfunctionality are features of effective control of viral replication.

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A epidemia causada pelo vírus da imunodeficiência humana (HIV) é a mais importante das ultimas décadas. A despeito dos avanços no conhecimento da patogenia do vírus e da resposta imune à infecção, até o momento não existe uma vacina eficaz contra a aquisição do HIV. Diversas linhas de evidência indicam que anticorpos neutralizantes ou ligadores, linfócitos T CD4+ e T CD8+ desempenham um papel importante na imunidade contra o HIV. Os anticorpos que são capazes de neutralizar o HIV são direcionados principalmente à glicoproteína do envelope do vírus (env), mas os candidatos vacinais baseados na proteína de envelope gp120 monomérica testados até hoje falharam em induzir proteção nos ensaios de eficácia. Avanços no entendimento da estrutura e função da glicoproteína env tem facilitado o desenvolvimento de uma nova geração de imunógenos baseada em trímeros mais estáveis e solúveis da glicoproteína gp140. Em uma formulação vacinal além da escolha do antígeno, os adjuvantes desempenham um papel fundamental. Os adjuvantes são conhecidos por aumentar a imunogenicidade das vacinas, e nos últimos anos vários compostos, incluindo agonistas de receptores do tipo Toll (TLR) e NOD (NLR) têm demonstrado eficácia em ensaios clínicos. Em estudos prévios, nosso grupo demonstrou que a imunização de camundongos com uma vacina de DNA codificando 18 epítopos para linfócitos T CD4+ do HIV-1 (HIVBr18), foi capaz de induzir resposta específica e ampla de linfócitos T CD4+ e T CD8+. Devido ao importante papel do efeito auxiliar de linfócitos T CD4+ na resposta humoral nas imunizações assistidas por diversos adjuvantes, o objetivo central do trabalho foi verificar se a imunização inicial com a vacina de DNA HIVBr18 seria capaz de aumentar a magnitude/qualidade de resposta imune humoral e celular induzida pelo trímero de gp140 na presença de diferentes adjuvantes. Para tal, camundongos BALB/c foram imunizados inicialmente com a vacina HIVBr18 ou com o vetor vazio e posteriormente com a proteína gp140 na presença dos adjuvantes: completo de Freund (ACF), poly IC, CpG ODN 1826, Monofosforil lipídeo A (MPL), Muramildipeptídeo (MDP), Imiquimod (R837), e Resiquimod (R848). Observamos que a imunização inicial com HIVBr18 foi capaz de fornecer um auxílio cognato para a proliferação específica de linfócitos T CD4+ e T CD8+ e também para a produção da citocina IFNy. A análise da xx resposta humoral mostrou que a imunização inicial com a vacina HIVBr18, foi capaz de influenciar a produção das subclasses de imunoglobulinas, independente do adjuvante testado. No presente trabalho, também analisamos a influência dos adjuvantes na imunogenicidade da gp140. Os animais que receberam os adjuvantes MPL, poly IC e CpG ODN 1826 apresentaram títulos de anticorpos estatisticamente superiores quando comparados aos animais que receberam os adjuvantes Alum, MDP, R837 e R848. Observamos que os animais imunizados com a gp140 na presença dos diferentes adjuvantes desenvolveram células B do centro germinativo e células TCD4+ auxiliar foliculares. Estes resultados nos permitem concluir que a imunização inicial com HIVBr18 é capaz de alterar a qualidade da resposta humoral e celular gp140- específica. Assim, essa formulação poderia ser utilizada para auxiliar e/ou direcionar a resposta imune induzida por outros imunógenos como por exemplo o trímero de gp140. Podemos concluir também que diferentes formulações de adjuvantes que se encontram em ensaios clínicos como poly IC, CpG ODN e MPL podem ser capazes de induzir um resposta imune humoral e celular tão ou mais potente que aquela induzida pelo ACF / The epidemic caused by the human immunodeficiency virus (HIV) is the most important in the last decades. Despite advances in the knowledge about virus pathogenesis and immune response to infection, until now there is not an effective vaccine against HIV acquisition. Several evidences indicate that neutralizing or binding antibodies, CD4+ and CD8+ T lymphocytes play an important role in immunity against HIV. The antibodies that are able to neutralize HIV are primarily directed against the virus envelope glycoprotein (env), but the vaccine candidates based on monomeric gp120 envelope protein tested so far failed to induce protection in efficacy trials. Advances in understanding the structure and function of the env glycoprotein have facilitated the development of a new generation of immunogens based on trimers, a more stable and soluble form of gp140 glycoprotein. In a vaccine formulation, in addition to the antigen, adjuvants play a pivotal role. Adjuvants are known to increase the immunogenicity of vaccines and, in the last years, several compounds, including agonists of Toll-like receptors (TLR) and NOD (NLR), have presented efficacy in clinical trials. In previous work, our group demonstrated that immunization of mice with a DNA vaccine (HIVBr18) encoding 18 CD4+ T cells epitopes from HIV-1 was able to induce a broad CD4+ T and CD8+ T cells specific response.. Given the important role of CD4+ T cells in the humoral response after adjuvant-assisted immunization, the aim of the study was to verify whether an initial immunization with the DNA vaccine HIVBr18 could increase the magnitude/quality of humoral and cellular immune response induced by gp140 trimer in the presence of different adjuvants. Therefore, BALB/c mice were initially immunized with the vaccine HIVBr18 or empty vector and then with gp140 in the presence of the following adjuvants: Freund\'s complete (CFA), poly IC, CpG ODN 1826, monophosphoryl lipid A (MPL), Muramyl dipeptide (MDP), Imiquimod (R837), and Resiquimod (R848). We observed that initial immunization with HIVBr18 was able to provide cognate help for specific CD4+ and CD8+ T cells proliferation and also for IFN-y production. Analysis of humoral response showed that initial immunization with the HIVBr18 vaccine was able to alter the production of immunoglobulin subclasses independent of the adjuvant tested. This work also analyzed the influence of adjuvants on the immunogenicity of gp140. Mice that received the adjuvant MPL, poly IC and CpG ODN 1826 presented higher antibody titers when compared to animals that received Alum, MDP, R837 and R848. We observed that mice immunized with gp140 in the presence of all adjuvants tested developed germinal center B cells and follicular helper T cells (TFH). We conclude that initial immunization with HIVBr18 is able to alter the quality of specific humoral and cellular immune responses.. Therefore, this formulation could be used in combination with other immunogens, such as gp140, to help/redirect the immune response. We also conclude that the adjuvants that are in clinical trials such as poly IC, MPL and CpG ODN 1826 may be able to induce stronger humoral and cellular response than CFA

A epidemia causada pelo vírus da imunodeficiência humana (HIV) é a mais importante das ultimas décadas. A despeito dos avanços no conhecimento da patogenia do vírus e da resposta imune à infecção, até o momento não existe uma vacina eficaz contra a aquisição do HIV. Diversas linhas de evidência indicam que anticorpos neutralizantes ou ligadores, linfócitos T CD4+ e T CD8+ desempenham um papel importante na imunidade contra o HIV. Os anticorpos que são capazes de neutralizar o HIV são direcionados principalmente à glicoproteína do envelope do vírus (env), mas os candidatos vacinais baseados na proteína de envelope gp120 monomérica testados até hoje falharam em induzir proteção nos ensaios de eficácia. Avanços no entendimento da estrutura e função da glicoproteína env tem facilitado o desenvolvimento de uma nova geração de imunógenos baseada em trímeros mais estáveis e solúveis da glicoproteína gp140. Em uma formulação vacinal além da escolha do antígeno, os adjuvantes desempenham um papel fundamental. Os adjuvantes são conhecidos por aumentar a imunogenicidade das vacinas, e nos últimos anos vários compostos, incluindo agonistas de receptores do tipo Toll (TLR) e NOD (NLR) têm demonstrado eficácia em ensaios clínicos. Em estudos prévios, nosso grupo demonstrou que a imunização de camundongos com uma vacina de DNA codificando 18 epítopos para linfócitos T CD4+ do HIV-1 (HIVBr18), foi capaz de induzir resposta específica e ampla de linfócitos T CD4+ e T CD8+. Devido ao importante papel do efeito auxiliar de linfócitos T CD4+ na resposta humoral nas imunizações assistidas por diversos adjuvantes, o objetivo central do trabalho foi verificar se a imunização inicial com a vacina de DNA HIVBr18 seria capaz de aumentar a magnitude/qualidade de resposta imune humoral e celular induzida pelo trímero de gp140 na presença de diferentes adjuvantes. Para tal, camundongos BALB/c foram imunizados inicialmente com a vacina HIVBr18 ou com o vetor vazio e posteriormente com a proteína gp140 na presença dos adjuvantes: completo de Freund (ACF), poly IC, CpG ODN 1826, Monofosforil lipídeo A (MPL), Muramildipeptídeo (MDP), Imiquimod (R837), e Resiquimod (R848). Observamos que a imunização inicial com HIVBr18 foi capaz de fornecer um auxílio cognato para a proliferação específica de linfócitos T CD4+ e T CD8+ e também para a produção da citocina IFNy. A análise da xx resposta humoral mostrou que a imunização inicial com a vacina HIVBr18, foi capaz de influenciar a produção das subclasses de imunoglobulinas, independente do adjuvante testado. No presente trabalho, também analisamos a influência dos adjuvantes na imunogenicidade da gp140. Os animais que receberam os adjuvantes MPL, poly IC e CpG ODN 1826 apresentaram títulos de anticorpos estatisticamente superiores quando comparados aos animais que receberam os adjuvantes Alum, MDP, R837 e R848. Observamos que os animais imunizados com a gp140 na presença dos diferentes adjuvantes desenvolveram células B do centro germinativo e células TCD4+ auxiliar foliculares. Estes resultados nos permitem concluir que a imunização inicial com HIVBr18 é capaz de alterar a qualidade da resposta humoral e celular gp140- específica. Assim, essa formulação poderia ser utilizada para auxiliar e/ou direcionar a resposta imune induzida por outros imunógenos como por exemplo o trímero de gp140. Podemos concluir também que diferentes formulações de adjuvantes que se encontram em ensaios clínicos como poly IC, CpG ODN e MPL podem ser capazes de induzir um resposta imune humoral e celular tão ou mais potente que aquela induzida pelo ACF / The epidemic caused by the human immunodeficiency virus (HIV) is the most important in the last decades. Despite advances in the knowledge about virus pathogenesis and immune response to infection, until now there is not an effective vaccine against HIV acquisition. Several evidences indicate that neutralizing or binding antibodies, CD4+ and CD8+ T lymphocytes play an important role in immunity against HIV. The antibodies that are able to neutralize HIV are primarily directed against the virus envelope glycoprotein (env), but the vaccine candidates based on monomeric gp120 envelope protein tested so far failed to induce protection in efficacy trials. Advances in understanding the structure and function of the env glycoprotein have facilitated the development of a new generation of immunogens based on trimers, a more stable and soluble form of gp140 glycoprotein. In a vaccine formulation, in addition to the antigen, adjuvants play a pivotal role. Adjuvants are known to increase the immunogenicity of vaccines and, in the last years, several compounds, including agonists of Toll-like receptors (TLR) and NOD (NLR), have presented efficacy in clinical trials. In previous work, our group demonstrated that immunization of mice with a DNA vaccine (HIVBr18) encoding 18 CD4+ T cells epitopes from HIV-1 was able to induce a broad CD4+ T and CD8+ T cells specific response.. Given the important role of CD4+ T cells in the humoral response after adjuvant-assisted immunization, the aim of the study was to verify whether an initial immunization with the DNA vaccine HIVBr18 could increase the magnitude/quality of humoral and cellular immune response induced by gp140 trimer in the presence of different adjuvants. Therefore, BALB/c mice were initially immunized with the vaccine HIVBr18 or empty vector and then with gp140 in the presence of the following adjuvants: Freund\'s complete (CFA), poly IC, CpG ODN 1826, monophosphoryl lipid A (MPL), Muramyl dipeptide (MDP), Imiquimod (R837), and Resiquimod (R848). We observed that initial immunization with HIVBr18 was able to provide cognate help for specific CD4+ and CD8+ T cells proliferation and also for IFN-y production. Analysis of humoral response showed that initial immunization with the HIVBr18 vaccine was able to alter the production of immunoglobulin subclasses independent of the adjuvant tested. This work also analyzed the influence of adjuvants on the immunogenicity of gp140. Mice that received the adjuvant MPL, poly IC and CpG ODN 1826 presented higher antibody titers when compared to animals that received Alum, MDP, R837 and R848. We observed that mice immunized with gp140 in the presence of all adjuvants tested developed germinal center B cells and follicular helper T cells (TFH). We conclude that initial immunization with HIVBr18 is able to alter the quality of specific humoral and cellular immune responses.. Therefore, this formulation could be used in combination with other immunogens, such as gp140, to help/redirect the immune response. We also conclude that the adjuvants that are in clinical trials such as poly IC, MPL and CpG ODN 1826 may be able to induce stronger humoral and cellular response than CFA

Current research on HIV therapy is diverse and multi-disciplinary. Engineers however, were late in joining the research movement and as such, engineering literature related to HIV chemotherapy is limited. Control engineers in particular, should have risen to the challenge, as it is apparent that HIV chemotherapy and control engineering have a lot in common. From a control theoretic point of view, HIV chemotherapy is control of a time varying nonlinear dynamical system with constrained controls. Once a suitable model has been developed or identified, control system theoretical concepts and design principles can be applied. The adopted control approach or strategy depends primarily on the control objectives, performance specifications and the control constraints. In principle, the designed control system can then be validated with clinical data. Obtaining measurements of the controlled variables however, has the potential to hinder effective control. The first part of this research focused on the application of control system analytical tools to HIV/AIDS models. The intention was to gain some insights into the HIV infection dynamics from a control theoretic perspective. The issues that needed to be addressed are: Persistent virus replication under potent HAART, variability in response to therapy between individuals on the same regimen, transient rebounds of plasma viremia after periods of suppression, the attainment, or lack thereof, of maximal and durable suppression of the viral load. The questions to answer were: When are the above mentioned observed responses to therapy most likely to occur as the HIV infection progresses, and does attaining one necessarily imply the other? Furthermore, the prognostic markers of virologic success, the possibility of individualizing therapy and timing the initiation of antiretroviral therapy such that the benefits of therapy are maximized, are matters that were also investigated. The primary objective of this thesis was to analyze models for the eventual control of the HIV infection. HIV therapy has multiple and often conflicting objectives, and these objectives had to be prioritized. The intention of the proposed control strategy was to produce practical solutions to the current antiretroviral problems. To this end, the second part of the research focused on addressing the HIV/AIDS control issues of sampling for effective control given the invasive nature of drawing blood from a patient and the derivation of drug dosage sequences to strike a balance between maximal suppression and toxicity reduction, when multiple drugs are concomitantly used to treat the infection. / Thesis (PhD)--University of Pretoria, 2006. / Electrical, Electronic and Computer Engineering / Unrestricted