Objective:
Toll-like receptor-3 agonist Poly-ICLC has been known to activate immune cells and induce HIV replication in pre-clinical experiments. In this study we investigated if Poly-ICLC could be used for disrupting HIV latency while simultaneously enhancing innate immune responses.
Design:
This was a randomized, placebo-controlled, double-blinded trial in aviremic, cART-treated HIV-infected subjects. Participants (
n
= 15) were randomized 3:1 to receive two consecutive daily doses of Poly-ICLC (1.4 mg subcutaneously) vs. placebo. Subjects were observed for adverse events, immune activation, and viral replication.
Methods:
Besides primary outcomes of safety and tolerability, several longitudinal immune parameters were evaluated including immune cell phenotype and function via flowcytometry, ELISA, and transcriptional profiling. PCR assays for plasma HIV-1 RNA, CD4
+
T cell-associated HIV-1 RNA, and proviral DNA were performed to measure HIV reservoirs and latency.
Results:
Poly-ICLC was overall safe and well-tolerated. Poly-ICLC-related adverse events were Grade 1/2, with the exception of one Grade 3 neutropenia which was short-lived. Mild Injection site reactions were observed in nearly all participants in the Poly-ICLC arm. Transcriptional analyses revealed upregulation of innate immune pathways in PBMCs following Poly-ICLC treatment, including strong interferon signaling accompanied by transient increases in circulating IP-10 (CXCL10) levels. These responses generally peaked by 24–48 h after the first injection and returned to baseline by day 8. CD4
+
T cell number and phenotype were unchanged, plasma viral control was maintained and no significant effect on HIV reservoirs was observed.
Conclusions:
These finding suggest that Poly-ICLC could be safely used for inducing transient innate immune responses in treated HIV
+
subjects indicating promise as an adjuvant for HIV therapeutic vaccines.
Trial Registration:
www.ClinicalTrials.gov
, identifier: NCT02071095.