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CD4 T cells are an important component of the immune system and the CD4 cell count is the main marker used to monitor immune decline during HIV infection. However this is an imperfect tool. We need ways to identify patients who are at risk of rapid disease progression (rapid progressors) before their CD4 count falls to low levels so they can be given priority access to life-saving HIV treatments.
In many resource limited countries, government has to prioritise treatment for people who are diagnosed with HIV. We also need a test to predict which patients’ CD4 count will not climb well once they start treatment (immunological non-responders) so they can start treatment earlier.
The aim of this project is to develop a validated prognostic test for these purposes. We have already shown that CD4 T cells have over-reactive metabolism in HIV+ individuals, compared to uninfected persons. We called this new phenomenon ‘metabolic exhaustion’, which causes the immune cells to die. Slowing down the metabolism in immune cells may improve CD4 T cell recovery and immune functions in people living with HIV.
Model: Calming the HIV storm: Reduce metabolic activity to treat disease. The Age, 2013
We will now explore our novel markers of glucose metabolism further in libraries of CD4 T cells collected from well-characterised cohorts of adults with HIV infection. Results will inform the development of a prognostic test with the potential to optimise HIV clinical care.
Model: Immune cells have over-reactive metabolism in people living with HIV, causing CD4 T cells to die by ‘Metabolic Exhaustion’. Palmer et al, EBiomedicine, 2016