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Naive infection predicts reservoir diversity and is a formidable hurdle to HIV eradication
Marilia R. Pinzone, … , Stephen Migueles, Una O’Doherty
Marilia R. Pinzone, … , Stephen Migueles, Una O’Doherty
Published July 6, 2021
Citation Information: JCI Insight. 2021;6(16):e150794. https://doi.org/10.1172/jci.insight.150794.
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Research Article AIDS/HIV Infectious disease

Naive infection predicts reservoir diversity and is a formidable hurdle to HIV eradication

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Abstract

Historically, naive cells have been considered inconsequential to HIV persistence. Here, we compared the contributions of naive and memory cells to the reservoirs of individuals with a spectrum of reservoir sizes and variable immunological control. We performed proviral sequencing of approximately 6000 proviruses from cellular subsets of 5 elite controllers (ECs) off antiretroviral therapy (ART) and 5 chronic progressors (CPs) on ART. The levels of naive infection were barely detectable in ECs and approximately 300-fold lower compared with those in CPs. Moreover, the ratio of infected naive to memory cells was significantly lower in ECs. Overall, the naive infection level increased as reservoir size increased, such that naive cells were a major contributor to the intact reservoir of CPs, whose reservoirs were generally very diverse. In contrast, the reservoirs of ECs were dominated by proviral clones. Critically, the fraction of proviral clones increased with cell differentiation, with naive infection predicting reservoir diversity. Longitudinal sequencing revealed that the reservoir of ECs was less dynamic compared with that of CPs. Naive cells play a critical role in HIV persistence. Their infection level predicts reservoir size and diversity. Moreover, the diminishing diversity of the reservoir as cellular subsets mature suggests that naive T cells repopulate the memory compartment and that direct infection of naive T cells occurs in vivo.

Authors

Marilia R. Pinzone, Sam Weissman, Alexander O. Pasternak, Ryan Zurakowski, Stephen Migueles, Una O’Doherty

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Figure 1

Comparison of naive and memory infection levels in ECs and CPs.

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Comparison of naive and memory infection levels in ECs and CPs.
(A) Leve...
(A) Levels of HIV DNA at enrollment in ECs (n = 5, blue) and CPs (n = 5, green). Levels of HIV DNA/million CD4+ T cells were significantly lower in ECs vs. CPs (21 [IQR, 4.5–129] vs. 3416 [IQR, 162–4383] copies/million CD4+ T cells, P = 0.02). (B) HIV DNA levels in the naive cells were approximately 300-fold lower in ECs (1.7 [IQR, 0.6–8.6] copies/million cells) compared with CPs (655 [IQR, 13.6–1239] copies/million cells, P = 0.02), whereas HIV DNA levels in memory cells were approximately 60-fold lower in ECs (46 [IQR, 14–244] copies/million cells) compared with CPs (3264 [IQR, 605–4718] copies/million cells, P = 0.02). (C) The ratio of naive/memory infection was significantly lower in ECs (0.04 [95% CI, 0.03–0.06]) compared with CPs (0.14 [95% CI, 0.13–0.16], P < 10–6). (D) Correlation between HIV DNA in naive cells and total HIV DNA (r = 0.86, P = 0.003) in ECs (n = 5) and CPs (n = 5). Lines represent median values. Groups were compared using the Mann-Whitney U test. Levels of HIV DNA are reported as copies/million cells. (B) Levels of memory infection were estimated based on levels of HIV DNA in Tcm, Tem, and Ttm cells corrected for the contribution of each subset to the CD4 population. The following formula was used: HIV DNA Tmem cells = (HIV DNA Tcm × Tcm /Total CD4) + (HIV DNA Ttm × Ttm /Total CD4) + (HIV DNA Tem × Tem /Total CD4). HIV DNA levels were estimated by qPCR with primers binding to the HIV LTR for CP2, CP3, CP4, CP5, and EC5 and by limiting dilution PCR for the remaining individuals, as described in Methods. Correlations were calculated using Spearman’s coefficient correlation. A modified Fisher’s exact test with a correction for uneven sampling of subsets was used to compare the ratio of infected naive to infected memory cells in ECs vs. CPs. ART, antiretroviral therapy; CPs, chronic progressors; ECs, elite controllers; LTR, long terminal region; naive T cells, naive CD4+ T cells; Tmem, memory CD4+ T cells.

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ISSN 2379-3708

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