Publications by authors named "Jean Pierre Routy"

We have shown that virus-specific CD4 and CD8 memory T cells (TM) induce autophagy after T cell receptor (TCR) engagement to provide free glutamine and fatty acids, including in people living with HIV-1 (PLWH). These nutrients fuel mitochondrial ATP generation through glutaminolysis and fatty acid oxidation (FAO) pathways, to fulfill the bioenergetic demands for optimal IL-21 and cytotoxic molecule production in CD4 and CD8 cells, respectively. Here, we expand our knowledge on how the metabolic events that occur in the mitochondria of virus-specific TM down-stream of the autophagy are regulated.

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Introduction: Castleman disease (CD) is a rare lymphoproliferative disorder having a variegated clinical presentation. Diagnosis of the idiopathic HIV- and HHV8-negative multicentric CD (iMCD) subtype poses a challenge given its non-specific clinical manifestations. iMCD presents as diffuse lymphadenopathy with inflammatory manifestations, primarily driven by interleukin-6 (IL-6).

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Antiretroviral therapy (ART) controls HIV-1 replication in people with HIV-1 (PWH), but immunological restauration at mucosal barrier surfaces is not achieved. This fuels microbial translocation, chronic immune activation, and increased comorbidities, including cardiovascular disease (CVD). Here, we sought to identify novel markers of mucosal barrier impairment in the blood to predict the HIV and/or CVD status.

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Background: A key research priority for developing an HIV cure strategy is to define the viral dynamics and biomarkers associated with sustained post-treatment control. The ability to predict the likelihood of sustained post-treatment control or non-control could minimize the time off antiretroviral therapy (ART) for those destined to not control and anticipate longer periods off ART for those destined to control.

Methods: Mathematical modeling and machine learning were used to characterize virologic predictors of long-term virologic control using viral kinetics data from several studies in which participants interrupted ART.

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HIV infection significantly affects the frequencies and functions of immunoregulatory CD3CD4CD8 double-negative (DN) T-cells, while the effect of early antiretroviral therapy (ART) initiation on these cells remains understudied. DN T-cell subsets were analyzed prospectively in 10 HIV+ individuals during acute infection and following early ART initiation compared to 20 HIV-uninfected controls. In this study, 21 Rhesus macaques (RMs) were SIV-infected, of which 13 were assessed during acute infection and 8 following ART initiation four days post-infection.

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Immunosenescence (ISC), the aging of the immune system, has largely been studied in populations of European descent. Here, circulating immune cell cytometric data from African-American, Hispanic, and non-Hispanic White participants were generated. Known and novel age effects were identified using either a meta-analysis approach or a parallel genetic approach.

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Article Synopsis
  • - T cell immune dysfunction is a significant issue in chronic HIV infection, and evaluating this dysfunction requires a method that involves both general and specific activation of T cells.
  • - Researchers developed a tunable artificial antigen-presenting cell (aAPC) system using silica microbeads, which showed that adding CD28 co-stimulation to anti-CD3 enhances T cell activation and cytokine production, especially IL-2.
  • - CD4 and CD8 T cells from untreated HIV patients displayed altered immune responses with a reduced dependence on CD28, and while antiretroviral therapy helps restore some functions in CD4 T cells, CD8 T cells remain impaired, suggesting persistent dysfunction linked to HIV.
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The mechanistic target of rapamycin (mTOR) positively regulates multiple steps of the HIV-1 replication cycle. We previously reported that a 12-week supplementation of antiretroviral therapy (ART) with metformin, an indirect mTOR inhibitor used in type-2 diabetes treatment, reduced mTOR activation and HIV transcription in colon-infiltrating CD4 T cells, together with systemic inflammation in nondiabetic people with HIV-1 (PWH). Herein, we investigated the antiviral mechanisms of metformin.

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The combination of ASC22, an anti-PD-L1 antibody potentially enhancing HIV-specific immunity and chidamide, a HIV latency reversal agent, may serve as a strategy for antiretroviral therapy-free virological control for HIV. People living with HIV, having achieved virological suppression, were enrolled to receive ASC22 and chidamide treatment in addition to their antiretroviral therapy. Participants were monitored over 24 weeks to measure changes in viral dynamics and the function of HIV-specific CD8 T cells (NCT05129189).

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Background: HIV drug resistance (HIV-DR) may jeopardize the benefit of antiretroviral therapy (ART) in treatment and prevention. This study utilized viral phylogenetics to resolve the influence of transmission networks on sustaining the spread of HIV-DR in Quebec spanning 2002 to 2022.

Methods: Time trends in acquired (ADR) and transmitted drug resistance (TDR) were delineated in treatment-experienced ( = 3500) and ART-naïve persons ( = 6011) with subtype B infections.

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Background: Despite successful antiretroviral therapy (ART), frequencies and immunological functions of memory CCR6 Th17-polarised CD4 T-cells are not fully restored in people with HIV (PWH). Moreover, long-lived Th17 cells contribute to HIV persistence under ART. However, the molecular mechanisms underlying these observations remain understudied.

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Article Synopsis
  • The study investigates the reemergence of Kaposi sarcoma (KS) in people living with HIV who are on antiretroviral therapy (ART), suggesting that age-related immune decline (immunosenescence) may play a role.
  • Researchers compared data, including immune responses and viral factors, from both HIV KS patients and classic KS patients who are HIV-uninfected, while also including age-matched controls.
  • Findings indicate that despite younger ages and favorable CD4 counts in HIV KS patients, their immune profiles are similar to those of older cKS patients, pointing towards the need for new strategies to prevent and treat KS in individuals receiving ART.
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  • - Cannabis-based medicines (CBMs) may help reduce systemic inflammation in adults with HIV, but a pilot study revealed challenges in participant enrollment and retention, as only 10 out of 205 approached individuals consented to join.
  • - The study focused on safety and tolerability of cannabidiol (CBD) and THC capsules over 12 weeks; while compliance was high, 30% of participants met all enrollment criteria due to stigma and scheduling issues.
  • - Despite these hurdles, 80% of enrolled participants completed the study, although two were withdrawn for health reasons, highlighting the need for ongoing efforts to address cannabis stigma and optimize study protocols for future research.
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Background: Socioeconomic status (SES) is a driver of health disparities and chronic diseases. People with HIV (PWH) are at risk for chronic liver diseases. We evaluated the association between low SES and hepatic outcomes in PWH.

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The intestinal environment facilitates HIV-1 infection via mechanisms involving the gut-homing vitamin A-derived retinoic acid (RA), which transcriptionally reprograms CD4 T cells for increased HIV-1 replication/outgrowth. Consistently, colon-infiltrating CD4 T cells carry replication-competent viral reservoirs in people with HIV-1 (PWH) receiving antiretroviral therapy (ART). Intriguingly, integrative infection in colon macrophages, a pool replenished by monocytes, represents a rare event in ART-treated PWH, thus questioning the effect of RA on macrophages.

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  • Scholars advocate for the quick provision of free HIV treatment to migrants living with HIV (MLWH) to improve their health outcomes and experiences.
  • In a 96-week study, MLWH received a specific medication and completed eight different surveys assessing factors like social support, stigma, psychological distress, and treatment satisfaction at various intervals.
  • The results showed that while MLWH generally had good treatment self-efficacy and satisfaction, their experiences of social support and stigma varied significantly based on sociodemographic factors, such as birth region and sexual orientation.
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COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3).

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Article Synopsis
  • Autoimmune diseases generally don’t prevent the use of immune checkpoint inhibitors (ICI) in cancer therapy, but they can lead to various immune-related adverse events (irAEs), including rare conditions like hemophagocytic lymphohistiocytosis (HLH).
  • A 79-year-old male with both untreated ankylosing spondylitis and gastric cancer experienced severe symptoms and lab findings indicating HLH after receiving ICIs, despite no signs of infection or hemophagocytosis in a bone marrow biopsy.
  • Treatment with glucocorticoids effectively managed the HLH without detracting from the ongoing anti-cancer effects, highlighting the need for further research into how autoimmune conditions and ICIs interact.
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Introduction: Growth differentiation factor 15 (GDF-15) was originally described as a stress-induced cytokine, and a biomarker of aging and cardiovascular diseases. We hypothesized that circulating GDF-15 would be associated with COVID-19 disease severity. Herein, we explored this hypothesis in a large cohort of COVID-19 patients.

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Antiretroviral therapies (ART) have reduced human immunodeficiency virus (HIV) infection-associated morbidity and mortality improving the life of people with HIV (PWH). However, ART lead to residual HIV production, which in conjunction with microbial translocation and immune dysfunction contributes to chronic inflammation and immune activation. PWH on ART remain at an increased risk for cardiovascular diseases (CVDs) including myocardial infarction and stroke; which in part is explained by chronic inflammation and immune activation.

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The mechanistic target of rapamycin (mTOR) positively regulates multiple steps of the HIV-1 replication cycle. We previously reported that a 12-weeks supplementation of antiretroviral therapy (ART) with metformin, an indirect mTOR inhibitor used in type-2 diabetes treatment, reduced mTOR activation and HIV transcription in colon-infiltrating CD4 T-cells, together with systemic inflammation in nondiabetic people with HIV-1 (PWH). Herein, we investigated the antiviral mechanisms of metformin.

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Background: Switching to the 2-drug regimen dolutegravir/lamivudine demonstrated durable non-inferior efficacy vs continuing 3- or 4-drug tenofovir alafenamide-based regimens for maintaining virologic suppression in people with HIV-1 through Week 144 in TANGO.

Setting: 134 centers, 10 countries.

Methods: Adults with HIV-1 RNA <50 copies/mL for >6 months and no history of virologic failure were randomized to switch from stable tenofovir alafenamide-based regimens to dolutegravir/lamivudine on Day 1 (early-switch group) for 196 weeks.

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Article Synopsis
  • COVID-19 self-testing strategies (COVIDST) are effective in identifying both symptomatic and asymptomatic cases of SARS-CoV-2, potentially lowering virus transmission.
  • A systematic review analyzed 70 studies from 25 countries, finding high specificity (98.37-99.71%) for COVIDST, with the highest sensitivity in symptomatic individuals and when using supervised testing methods or digital tools.
  • Overall acceptability of self-testing was high (91.0-98.7%), though daily self-testing had lower acceptance, and the feasibility varied significantly, especially for repeated testing.
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We have previously shown that blood levels of B-cell Activating Factor (BAFF) rise relatively to disease progression status in the context of HIV-1 infection. Excess BAFF was concomitant with hyperglobulinemia and the deregulation of blood B-cell populations, notably with increased frequencies of a population sharing characteristics of transitional immature and marginal zone (MZ) B-cells, which we defined as marginal zone precursor-like" (MZp). In HIV-uninfected individuals, MZp present a B-cell regulatory (Breg) profile and function, which are lost in classic-progressors.

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