Abstract
Changes in the cellular microRNA (miRNA) expression profile in response to HIV infection, replication or latency have been reported. Nevertheless, little is known concerning the abundance of miRNA in extracellular vesicles (EVs). In the search for a reliable predictor of viral rebound, we quantified the amount of miR-29a, miR-146a, and miR-155 in two types of plasma extracellular vesicles. Venous blood was collected from 235 ART-treated and ART-naive persons living with HIV (85 with ongoing viral replication, ≥20 copies/mL) and 60 HIV-negative participants at five HIV testing or treatment centers in Burkina Faso. Large and small plasma EVs were purified and counted, and mature miRNA miR-29a, miR-146a, and miR-155 were measured by RT-qPCR. Diagnostic performance of miRNA levels in large and small EVs was evaluated by a receiver operating characteristic curve analysis. The median duration of HIV infection was 36 months (IQR 14–117). The median duration of ART was 34 months (IQR 13–85). The virus was undetectable in 63.8% of these persons. In the others, viral load ranged from 108 to 33,978 copies/mL (median = 30,032). Large EVs were more abundant in viremic participants than aviremic. All three miRNAs were significantly more abundant in small EVs in persons with detectable HIV RNA, and their expression levels in copies per vesicle were a more reliable indicator of viral replication in ART-treated patients with low viremia (20–1000 copies/mL). HIV replication increased the production of large EVs more than small EVs. Combined with viral load measurement, quantifying EV-associated miRNA abundance relative to the number of vesicles provides a more reliable marker of the viral status. The expression level as copies per small vesicle could predict the viral rebound in ART-treated patients with undetectable viral loads.
Highlights
Human immunodeficiency virus (HIV) causes a chronic infection characterized by reservoirs of latent retroviruses, making its eradication in the host very difficult [1]
We investigate the miR-29a, miR-146a, and miR-155 expression levels in large and small plasma extracellular vesicles (EVs) purified from HIV patients with and without viral replication and evaluate the potential of this measurement as a rapid clinical test for identifying viremic patients
EV populations found in plasma from Antiretroviral therapy (ART)-naive people living with HIV (PLWH) are more abundant than in successfully treated ART patients [29]
Summary
Human immunodeficiency virus (HIV) causes a chronic infection characterized by reservoirs of latent retroviruses, making its eradication in the host very difficult [1]. Antiretroviral therapy (ART) suppresses virions replication, keeping it below detectable levels or at a low level of viremia in conjunction with small numbers of infected cells [1–3]. Maintaining this suppression requires long-term adherence to ART with regular monitoring of viremia. It is defined as a persistent detectable level of HIV RNA arising in the blood after a period of suppression. Rebounds and persistent episodes of low-level detectable viremia are associated with a greater risk of subsequent virological failure, drug resistance, and impaired immune status [4–6]
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