Abstract

The importance of myeloid cells in HIV transmission in the female genital tract is uncertain. Because it is difficult to study the early events in HIV transmission in humans, most of our knowledge is based on animal models of SIV infection in Rhesus macaques and more recently HIV infection in humanized mice. However, these models may not accurately recapitulate transmission in the human genital tract. CD14+ myeloid cells are the most abundant hematopoietic cells in the human cervical mucosa, comprising 40–50% of CD45+ mononuclear cells. Most CD14+ cells are CD14+CD11c– macrophages and about a third are CD14+CD11c+ tissue dendritic cells, which express the HIV-binding receptors, DC-SIGN and CX3CR1. To examine the role of mucosal myeloid cells in HIV transmission, we infected intact healthy human cervical explants with CCR5–tropic HIV-1 ex vivo and then sorted populations of cervical immune cells 20 h later to determine whether they took up virus and could transmit it to activated CD4 T cells. Viral RNA was detected in CD14+ myeloid cells in all but one of 10 donor tissue samples, even when HIV RNA was not detected in CD4+ T cells. HIV RNA was detected predominantly in CD14+CD11c+ dendritic cells rather than in CD14+CD11c– macrophages. The reverse transcriptase inhibitor, nevirapine, reduced HIV RNA in CD4+ T cells, but not in CD14+ cells. Moreover, integrated HIV DNA were not detected above background in myeloid cells but was detected in T cells. These data suggest that although HIV replicates in T cells, myeloid cells in the female genital mucosa capture viral particles, but do not replicate the virus at early timepoints. However, sorted CD14+ myeloid cells isolated 20 h post-infection from 5 HIV-infected cervical explants tested all transmitted HIV to activated CD4+ T cells, while only 1 sample of sorted CD4+ T cells did. Thus, myeloid cells in human cervical tissue capture HIV and are an important early cellular storage site of infectious virus.

Highlights

  • Because studying sexual transmission of HIV in humans is difficult, models of heterosexual transmission are largely based on studies of SIV transmission in female Rhesus macaques [1, 2]

  • HIV RNA was detected in CD14+ cells even when it was not detected in CD4+ T cells

  • The purity of the sorted populations was confirmed by measuring CD4 mRNA by qRT-PCR; the sorted CD4+ T cell samples had much higher CD4 expression than the CD14+ myeloid cells, and CD4 mRNA was not detected in the sorted CD8+ T cells (Figure 1C)

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Summary

Introduction

Because studying sexual transmission of HIV in humans is difficult, models of heterosexual transmission are largely based on studies of SIV transmission in female Rhesus macaques [1, 2]. Results in the macaque SIV model might not translate to human HIV. Human and non-human primate microbiota in the female genital mucosa, which affect transmission [3], are different. SIV infection of primate immune cells differs from HIV-1. The efficiency of reverse transcription is reduced in non-dividing cells by the host factor SAMHD1, the Vpx accessory protein in SIV and HIV-2 overcomes SAMHD1’s activity by promoting SAMHD1 degradation [4,5,6,7]. Even amongst HIV strains and human subjects, HIV strain variations, vaginal infection and inflammation, and genetic variations strongly influence sexual transmission

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