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Subtype C HIV-1 reservoirs throughout the body in ART-suppressed individuals
Zhou Liu, … , John T. West, Charles Wood
Zhou Liu, … , John T. West, Charles Wood
Published October 24, 2022
Citation Information: JCI Insight. 2022;7(20):e162604. https://doi.org/10.1172/jci.insight.162604.
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Research Article AIDS/HIV Virology

Subtype C HIV-1 reservoirs throughout the body in ART-suppressed individuals

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Abstract

Subtype B HIV-1 reservoirs have been intensively investigated, but reservoirs in other subtypes and how they respond to antiretroviral therapy (ART) is substantially less established. To characterize subtype C HIV-1 reservoirs, we implemented postmortem frozen, as well as formalin fixed paraffin embedded (FFPE) tissue sampling of central nervous system (CNS) and peripheral tissues. HIV-1 LTR, gag, envelope (env) DNA and RNA was quantified using genomic DNA and RNA extracted from frozen tissues. RNAscope was used to localize subtype C HIV-1 DNA and RNA in FFPE tissue. Despite uniform viral load suppression in our cohort, PCR results showed that subtype C HIV-1 proviral copies vary both in magnitude and tissue distribution, with detection primarily in secondary lymphoid tissues. Interestingly, the appendix harbored proviruses in all subjects. Unlike subtype B, subtype C provirus was rarely detectable in the CNS, and there was no detectable HIV-1 RNA. HIV-1 RNA was detected in peripheral lymphoid tissues of 6 out of 8 ART-suppressed cases. In addition to active HIV-1 expression in lymphoid tissues, RNAscope revealed HIV RNA detection in CD4-expressing cells in the appendix, suggesting that this tissue was a previously unreported potential treatment-resistant reservoir for subtype C HIV-1.

Authors

Zhou Liu, Peter Julius, Guobin Kang, John T. West, Charles Wood

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Figure 1

HIV-1 aviremic cohort and postmortem sample collection.

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HIV-1 aviremic cohort and postmortem sample collection.
(A) The flow dia...
(A) The flow diagram showed postmortem HIV-1 screening. HIV serologic tests were conducted on plasma samples of all postmortem cases to identify HIV-1–infected individuals. qPCR was utilized for plasma viral load detection, and those cases with undetectable plasma viral load were then subjected for HIV-1 subtyping to confirm clade C HIV-1 infection in those aviremic individuals. Eventually, an 8-case cohort was identified to be infected with subtype C HIV-1. Viral DNA and RNA copies were determined by different PCR-based methods from frozen tissue genomic DNA and total RNA. To characterize more detail for subtype C HIV-1 reservoirs, RNAscope was performed on representative FFPE tissues. (B) Postmortem samples were collected within 48 hours of a subject’s death. Half of each brain and peripheral tissue was collected and processed into a frozen sample, while the other half was processed into a FFPE sample. Frozen plasma samples were also collected.

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