Go to The Journal of Clinical Investigation
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
  • Physician-Scientist Development
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Immunology
    • Metabolism
    • Nephrology
    • Oncology
    • Pulmonology
    • All ...
  • Videos
  • Collections
    • In-Press Preview
    • Resource and Technical Advances
    • Clinical Research and Public Health
    • Research Letters
    • Editorials
    • Perspectives
    • Physician-Scientist Development
    • Reviews
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • In-Press Preview
  • Resource and Technical Advances
  • Clinical Research and Public Health
  • Research Letters
  • Editorials
  • Perspectives
  • Physician-Scientist Development
  • Reviews
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
Naive infection predicts reservoir diversity and is a formidable hurdle to HIV eradication
Marilia R. Pinzone, Sam Weissman, Alexander O. Pasternak, Ryan Zurakowski, Stephen Migueles, Una O’Doherty
Marilia R. Pinzone, Sam Weissman, Alexander O. Pasternak, Ryan Zurakowski, Stephen Migueles, Una O’Doherty
View: Text | PDF
Research Article AIDS/HIV Infectious disease

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

  • Text
  • PDF
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

×

Figure 3

HIV RNA levels in naive and memory cells of CPs.

Options: View larger image (or click on image) Download as PowerPoint
HIV RNA levels in naive and memory cells of CPs.
(A) Levels of US HIV RN...
(A) Levels of US HIV RNA were significantly lower in naive cells (median value 171 [IQR, 8.2–739] copies/μg total RNA cells) when compared with memory cells (P = 0.02 by Friedman’s test) in 4 CPs on ART. The comparison was statistically significant only in Tcm vs. naive T cells (P = 0.04), likely due to the small sample size. Levels of US HIV RNA in memory cells were similar across subsets, ranging from 1534 (IQR, 221–5748) to 1136 (IQR, 288–2129) to 1601 (IQR, 422–2933) copies/μg total RNA in Tcm, Ttm, and Tem cells, respectively. (B) More importantly, the US HIV RNA/HIV DNA ratio trended toward lower values in naive cells (0.18 [0.04–0.54]) compared with memory cells (1.1 [0.92–2.5]). CP2 was excluded as the levels of HIV RNA were undetectable. With the exception of EC5, none of the ECs had detectable levels of HIV RNA in unfractionated CD4+ T cells. Lines represent median values. Groups were compared using the Friedman’s test. The Dunn’s test was used to correct for multiple comparisons. The gray symbols depict undetectable values, censored to 50% of the corresponding detection limits. ART, antiretroviral therapy; CP,s chronic progressors; ECs, elite controllers; naive T cells, naive CD4+ T cells; Tcm, central memory CD4+ T cells; Ttm, transitional memory CD4+ T cells; Tem, effector memory CD4+ T cells; US, unspliced.

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

Sign up for email alerts