Superior control of HIV-1 replication by CD8⁺ T cells is reflected by their avidity, polyfunctionality, and clonal turnover

The key attributes of CD8⁺ T cell protective immunity in human immunodeficiency virus (HIV) infection remain unclear. We report that CD8⁺ T cell responses specific for Gag and, in particular, the immunodominant p24 epitope KK10 correlate with control of HIV-1 replication in human histocompatibility leukocyte antigen (HLA)–B27 patients. To understand further the nature of CD8⁺ T cell–mediated antiviral efficacy, we performed a comprehensive study of CD8⁺ T cells specific for the HLA-B27–restricted epitope KK10 in chronic HIV-1 infection based on the use of multiparametric flow cytometry together with molecular clonotypic analysis and viral sequencing. We show that B27-KK10–specific CD8⁺ T cells are characterized by polyfunctional capabilities, increased clonal turnover, and superior functional avidity. Such attributes are interlinked and constitute the basis for effective control of HIV-1 replication. These data on the features of effective CD8⁺ T cells in HIV infection may aid in the development of successful T cell vaccines.