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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
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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 4

The diversity of the HIV reservoir correlates with the levels of naive infection and decreases as cells become more differentiated.

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The diversity of the HIV reservoir correlates with the levels of naive i...
(A) The proportion of repeated sequences detected by NFL proviral sequencing was significantly higher in CD4+ T cells of ECs compared with CPs (74% [IQR, 41%–83%] vs. 15% [IQR, 9%–39%], P = 0.02). (B) The fraction of repeated sequences steadily increased from naive T cells (2% [IQR, 0%–18%]) to Tcm (24% [IQR, 10%–41%]) to Ttm (53% [IQR, 28%–73%]) to Tem (56% [IQR, 43%–71%] cells, P = 0.002), reaching statistical significance for naive T cells vs. Tem (P = 0.006) and naive T cells vs. Ttm (P = 0.01). (C) The levels of naive infection significantly correlated with the proportion of unique sequences in CD4+ T cells (r = 0.75, P = 0.02). All panels include 5 ECs off ART and 5 CPs whose cells were collected 2–3 years after ART initiation. Lines represent median values. Groups were compared using the Mann-Whitney U test in A and Friedman’s test in B (with Dunn’s correction for multiple comparisons). Levels of HIV DNA are reported as copies/million cells. The correlation in C was calculated using the Spearman’s coefficient correlation. ART, antiretroviral therapy; CPs, chronic progressors; ECs, elite controllers; NFL, near-full-length; 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.

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