Abstract HIV-1 infection disrupts the cortical actin network, leading to morphological and migratory changes in CD4+ T cells. We utilized time-lapse and ultrastructural microscopy to observe primary CD4+ T cells infected with wild-type HIV-1 and Nef-deleted (ΔNef) virus to assess cytoskeletal cytopathicity. Furthermore, we investigated the link between HIV-1-mediated actin disruption and primary immunodeficiencies that affect the ARP2/3 complex to cytopathicities found in HIV infection. Of the five aberrant phenotypes observed, we identified two novel pathological morphologies unique to HIV-1 infected CD4+ T cells. The observed morphologies mirror those seen in migrating cells containing genetic determinants of primary immunodeficiencies affecting ARP2/3 complex. Nef-deleted virus partially ameliorated the cytopathicity in infected cells. In contrast to normal progressors and healthy controls, two-thirds of HIV-1 controllers tested retained cortical actin stability in the presence of WT infection. The link between these cellular pathologies and disease progression provides insights into HIV-1 induced immune dysfunction. Additionally, we observed that certain HIV-1 controllers lack these cellular pathologies, possibly indicating a protective mechanism against viral replication and immune response. Restoring ARP2/3 function and cortical actin integrity in HIV-1-infected individuals may present a promising avenue for eradicating infected cells from the body.
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