People living with HIV are disproportionately affected by HBV infection, with approximately one in ten people with HIV also living with chronic HBV.
This new study, published in Gut, a journal of the British Medical Journal, looked at immune cells from people with HBV alone, HIV alone, or both infections together, all of whom were receiving effective long-term treatment. Researchers focused on CD8+ T cells - a type of white blood cell that plays a critical role in recognising and killing virus-infected cells.
Chronic HBV is known to wear down these immune cells over time and can leave them exhausted with less ability to control infection. Doctors and scientists have traditionally believed this problem would be even more severe with people who also have HIV; however, this research shows a more complex and hopeful picture for patients.
The UCL Institute of Immunity and Transplantation team, supported by colleagues at the University of Oxford, Queen Mary University of London and the Royal Free London NHS Foundation Trust, examined CD8+ T cell responses in 61 participants on suppressive antiviral therapy.
They found that people with HBV/HIV coinfection have a higher proportion of stem-like CD8+ T cells, which can retain their ability to renew themselves and respond when needed. This stem-like state allows the immune system to keep mounting effective responses against HBV, even after a long period of chronic infection.
The findings have important clinical implications, particularly for the design of tailored immunotherapies, emphasising early intervention and identifying which patients might be most suitable candidates for checkpoint-based treatments as part of functional cure strategies.
This is the first study to comprehensively examine immune responses in people with HBV/HIV coinfection in the current antiretroviral therapy era, and the findings challenge long-held assumptions in the field.
This research was funded by the National Institutes of Health (NIH R01AI55182). The full paper can be read here.
For many years, people living with both HBV and HIV have been assumed to have more severely damaged immune responses and were often excluded from cure-focused studies. Our findings challenge that view.
We show that when both viruses are well controlled, these individuals can preserve a pool of stem-like immune cells that remain functional and responsive. This opens up new opportunities to rethink who may benefit most from immune-based therapies aimed at achieving a functional cure of HBV.
Antiviral Vaccines and Therapies
We focus on translating our research findings into novel approaches to prophylactic vaccination (e.g. against coronavirus) and therapeutic vaccination (and hepatitis B virus).
Institute of Immunity and Transplantation
The UCL Institute of Immunity & Transplantation (IIT) is a world-class centre of excellence dedicated to the study of the immune system.
Division of Infection and Immunity
A centre for teaching and research excellence in immunology, pathogen evolution and host-pathogen interaction.
