Abstract

Despite long-term antiretroviral therapy (ART), HIV-1 persists within a reservoir of CD4+ T cells that contribute to viral rebound if treatment is interrupted. Identifying the cellular populations that contribute to the HIV-1 reservoir and understanding the mechanisms of viral persistence are necessary to achieve an effective cure. In this regard, through Full-Length Individual Proviral Sequencing, we observed that the HIV-1 proviral landscape was different and changed with time on ART across naive and memory CD4+ T cell subsets isolated from 24 participants. We found that the proportion of genetically intact HIV-1 proviruses was higher and persisted over time in effector memory CD4+ T cells when compared with naive, central, and transitional memory CD4+ T cells. Interestingly, we found that escape mutations remained stable over time within effector memory T cells during therapy. Finally, we provided evidence that Nef plays a role in the persistence of genetically intact HIV-1. These findings posit effector memory T cells as a key component of the HIV-1 reservoir and suggest Nef as an attractive therapeutic target.

Highlights

  • Genetic characterization of HIV-1 proviruses isolated from individuals on suppressive antiretroviral therapy (ART) has revealed that 2-8% of persistent HIV-1 is genetically71 intact and potentially replication-competent [1,2,3,4,5,6]

  • Genetically-intact HIV-1 proviruses isolated from ART-suppressed individuals 131 are enriched within TEM CD4+ T-cells

  • We reported that genetically-intact and potentially replication-competent HIV-1 proviruses are unequally distributed between TN and memory CD4+ T-cell subsets and proposed that TEM CD4+ T-cells are an important component of the HIV135 1 reservoir in 6 participants [4]

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Summary

Introduction

Genetic characterization of HIV-1 proviruses isolated from individuals on suppressive antiretroviral therapy (ART) has revealed that 2-8% of persistent HIV-1 is genetically intact and potentially replication-competent [1,2,3,4,5,6]. Replication-competent proviruses are the main barrier to HIV-1 eradication as they contribute to rebound in viral load if therapy is interrupted [7, 8]. For this reason, determining the source of replication competent HIV-1 is critical to identify cellular targets for future curative strategies. To investigate the distribution of genetically-intact and potentially replication-competent HIV-1 proviruses within TN, central (TCM), transitional (TTM), and effector (TEM) memory CD4+ T-cell subsets, our group developed the Full-Length Individual Proviral Sequencing (FLIPS) assay [4, 12]. Understanding the distribution of replication-competent HIV-1 between TN and memory CD4+ T-cell subsets and how replication-competent HIV-1 proviruses are maintained during long-term ART deserves further analysis

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