æ T cells mediate robust anti-HIV functions during antiretroviral therapy regardless of immune checkpoint expression

Objectives. Although antiretroviral therapy (ART) efficiently suppresses HIV viral load, immune dysregulation and dysfunction persist in people living with HIV (PLWH). gamma delta T cells are functionally impaired during untreated HIV infection, but the extent to which they are reconstituted upon ART is currently unclear. Methods. Utilising a cohort of ART-treated PLWH, we assessed the frequency and phenotype, characterised in vitro functional responses and defined the impact of immune checkpoint marker expression on effector functions of both V delta 1 and V delta 2 T cells. We additionally explore the in vitro expansion of V delta 2 T cells from PLWH on ART and the mechanisms by which such expanded cells may sense and kill HIV-infected targets. Results. A matured NK cell-like phenotype was observed for V delta 1 T cells among 25 ART-treated individuals (PLWH/ART) studied compared to 17 HIV-uninfected controls, with heightened expression of 2B4, CD160, TIGIT and Tim-3. Despite persistent phenotypic perturbations, V delta 1 T cells from PLWH/ART exhibited strong CD16-mediated activation and degranulation, which were suppressed upon Tim-3 and TIGIT crosslinking. V delta 2 T cell degranulation responses to the phosphoantigen (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate at concentrations up to 2 ng mL(-1) were significantly impaired in an immune checkpoint-independent manner among ART-treated participants. Nonetheless, expanded V delta 2 T cells from PLWH/ART retained potent anti-HIV effector functions, with the NKG2D receptor contributing substantially to the elimination of infected cells. Conclusion. Our findings highlight that although significant perturbations remain within the gamma delta T cell compartment throughout ART-treated HIV, both subsets retain the capacity for robust anti-HIV effector functions.