E mutations. Among the antiretroviral drugs, integrase inhibitors would be suitable

E mutations. Among the antiretroviral drugs, integrase inhibitors would be suitable to decrease the archived virus and, if not used as first line, could be used at switch or at treatment intensification [17]. 1317923 We cannot rule out that these mutations were selected during the reduction of viral Title Loaded From File replication between the initiation of ART and the first point of VL below the threshold, so it would be interesting to have UDPS data from very recently treated patients to address this issue. The second issue is that, although they were obtained by simulation and not by biological assays (for example, ELIspot) which could hardly be used on a large scale, our results show that curative vaccination with generic epitopes, mainly CTL epitopes, cannot be fully efficient. The epitopes are different from the B reference or are modified when they are archived, as already described [18], and one cannot expect a cross-reaction. Furthermore, these generic epitopes are not systematically suitable for presentation owing toToward a New Concept of HIV Vaccinethe diversity of class I antigens and corresponding HLA alleles. This is a problem not only for Lipo5 peptides but also for all other generic vaccines based on recombinant viruses or viral DNA [19]. On the other hand, when one first identifies the HLA I alleles and designs potential peptide epitopes on the HXB2 reference, one 18204824 should be aware that some of these epitopes may be different in the archived provirus. Even the viral RNA reference before initiation of ART can be a decoy because the archived epitopes may be different. If one assumes that the archived proviral DNA is the major origin of viral replication at Title Loaded From File failure or treatment interruption, we propose that vaccinal epitopes should be selected from the sequenced proviral DNA, in agreement with the HLA alleles of the patients. We plan to extend this study on three different levels: a) on the individual level with a specific analysis of the archived CTL HIV-1 epitopes in one of the main tissue reservoirs, i.e. the gut, and in the long-term cellular reservoir represented by memory resting T cells; b) on the individual level in patients close to primary infection and whose virus is considered to exhibit a lower genomic and antigenic evolution, particularly at positions of CTL epitopes; c) on the population level with recruitment of patients having a different genetic background and infected mainly with non-B HIV-1. In conclusion, our study opens up therapeutic and vaccinal perspectives in those patients who are considered to be fully responding with ART. A new concept of curative vaccine is proposed where viral CTL epitopes are designated after sequencing of archived proviral DNA and matching with HLA alleles before undertaking vaccination.Methods Study PatientsEleven HIV-1 infected patients were enrolled in this study which received authorisation from the ?Comite de protection des ?personnes du Sud Ouest ?(DC 2012/48). Written informed consent was obtained from each participant. All were adults responding successfully to a first ART including at least one NRTI and/or NNRTI. Written informed consent was obtained from each participant. The first-line ART period ranged from 8 months to 9 years with undetectable viral load (fewer than 50 copies/ml Roche Ampliprep Cobas Taqman and fewer than 40 copies/ml Abbott) and without intermittent viremia or blip. At initiation of ART, the median number of TCD4 lymphocytes was 238/uL (range 5?34).Hybridization probes (Ro.E mutations. Among the antiretroviral drugs, integrase inhibitors would be suitable to decrease the archived virus and, if not used as first line, could be used at switch or at treatment intensification [17]. 1317923 We cannot rule out that these mutations were selected during the reduction of viral replication between the initiation of ART and the first point of VL below the threshold, so it would be interesting to have UDPS data from very recently treated patients to address this issue. The second issue is that, although they were obtained by simulation and not by biological assays (for example, ELIspot) which could hardly be used on a large scale, our results show that curative vaccination with generic epitopes, mainly CTL epitopes, cannot be fully efficient. The epitopes are different from the B reference or are modified when they are archived, as already described [18], and one cannot expect a cross-reaction. Furthermore, these generic epitopes are not systematically suitable for presentation owing toToward a New Concept of HIV Vaccinethe diversity of class I antigens and corresponding HLA alleles. This is a problem not only for Lipo5 peptides but also for all other generic vaccines based on recombinant viruses or viral DNA [19]. On the other hand, when one first identifies the HLA I alleles and designs potential peptide epitopes on the HXB2 reference, one 18204824 should be aware that some of these epitopes may be different in the archived provirus. Even the viral RNA reference before initiation of ART can be a decoy because the archived epitopes may be different. If one assumes that the archived proviral DNA is the major origin of viral replication at failure or treatment interruption, we propose that vaccinal epitopes should be selected from the sequenced proviral DNA, in agreement with the HLA alleles of the patients. We plan to extend this study on three different levels: a) on the individual level with a specific analysis of the archived CTL HIV-1 epitopes in one of the main tissue reservoirs, i.e. the gut, and in the long-term cellular reservoir represented by memory resting T cells; b) on the individual level in patients close to primary infection and whose virus is considered to exhibit a lower genomic and antigenic evolution, particularly at positions of CTL epitopes; c) on the population level with recruitment of patients having a different genetic background and infected mainly with non-B HIV-1. In conclusion, our study opens up therapeutic and vaccinal perspectives in those patients who are considered to be fully responding with ART. A new concept of curative vaccine is proposed where viral CTL epitopes are designated after sequencing of archived proviral DNA and matching with HLA alleles before undertaking vaccination.Methods Study PatientsEleven HIV-1 infected patients were enrolled in this study which received authorisation from the ?Comite de protection des ?personnes du Sud Ouest ?(DC 2012/48). Written informed consent was obtained from each participant. All were adults responding successfully to a first ART including at least one NRTI and/or NNRTI. Written informed consent was obtained from each participant. The first-line ART period ranged from 8 months to 9 years with undetectable viral load (fewer than 50 copies/ml Roche Ampliprep Cobas Taqman and fewer than 40 copies/ml Abbott) and without intermittent viremia or blip. At initiation of ART, the median number of TCD4 lymphocytes was 238/uL (range 5?34).Hybridization probes (Ro.