Recent studies have suggested greater HIV cure potential among infected children than adults. A major obstacle to HIV eradication in adults is that the viral reservoir is largely comprised of HIV-specific cytotoxic T lymphocyte (CTL) escape variants. We here evaluate the potential for CTL in HIV-infected slow-progressor children to play an effective role in “shock-and-kill” cure strategies. Two distinct subgroups of children were identified on the basis of viral load. Unexpectedly, in both groups, as in adults, HIV-specific CTL drove the selection of escape variants across a range of epitopes within the first weeks of infection. However, in HIV-infected children, but not adults, de novo autologous variant-specific CTL responses were generated, enabling the pediatric immune system to “corner” the virus. Thus, even when escape variants are selected in early infection, the capacity in children to generate variant-specific anti-HIV CTL responses maintains the potential for CTL to contribute to effective shock-and-kill cure strategies in pediatric HIV infection.

最近的研究表明，与成人相比，受感染儿童的 HIV 治愈潜力更大。在成人中根除 HIV 的一个主要障碍是病毒库主要由 HIV 特异性细胞毒性 T 淋巴细胞 (CTL) 逃逸变异体组成。我们在这里评估了 CTL 在感染 HIV 的进展缓慢的儿童中在“电击和杀死”治疗策略中发挥有效作用的潜力。根据病毒载量确定了两个不同的儿童亚组。出乎意料的是，在两组中，就像在成人中一样，HIV 特异性 CTL 在感染的前几周内推动了一系列表位的逃逸变异的选择。然而，在感染 HIV 的儿童而非成人中，会产生从头自体变异特异性 CTL 反应，使儿童免疫系统能够“控制”病毒。因此，