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Naive infection predicts reservoir diversity and is a formidable hurdle to HIV eradication
Marilia R. Pinzone, Sam Weissman, Alexander O. Pasternak, Ryan Zurakowski, Stephen Migueles, Una O’Doherty
Marilia R. Pinzone, Sam Weissman, Alexander O. Pasternak, Ryan Zurakowski, Stephen Migueles, Una O’Doherty
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Research Article AIDS/HIV Infectious disease

Naive infection predicts reservoir diversity and is a formidable hurdle to HIV eradication

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Abstract

Historically, naive cells have been considered inconsequential to HIV persistence. Here, we compared the contributions of naive and memory cells to the reservoirs of individuals with a spectrum of reservoir sizes and variable immunological control. We performed proviral sequencing of approximately 6000 proviruses from cellular subsets of 5 elite controllers (ECs) off antiretroviral therapy (ART) and 5 chronic progressors (CPs) on ART. The levels of naive infection were barely detectable in ECs and approximately 300-fold lower compared with those in CPs. Moreover, the ratio of infected naive to memory cells was significantly lower in ECs. Overall, the naive infection level increased as reservoir size increased, such that naive cells were a major contributor to the intact reservoir of CPs, whose reservoirs were generally very diverse. In contrast, the reservoirs of ECs were dominated by proviral clones. Critically, the fraction of proviral clones increased with cell differentiation, with naive infection predicting reservoir diversity. Longitudinal sequencing revealed that the reservoir of ECs was less dynamic compared with that of CPs. Naive cells play a critical role in HIV persistence. Their infection level predicts reservoir size and diversity. Moreover, the diminishing diversity of the reservoir as cellular subsets mature suggests that naive T cells repopulate the memory compartment and that direct infection of naive T cells occurs in vivo.

Authors

Marilia R. Pinzone, Sam Weissman, Alexander O. Pasternak, Ryan Zurakowski, Stephen Migueles, Una O’Doherty

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Figure 2

The intact reservoir is substantial in naive T cells of CPs but largely contained by memory cells in ECs.

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The intact reservoir is substantial in naive T cells of CPs but largely ...
(A) Contribution of T cell subsets to the intact reservoir of CPs 2–3 years after ART initiation (n = 5). Naive cells represented a major contributor to the intact reservoir, with a median contribution of 39% (IQR, 12%–53%), followed by Tcm cells (20% [IQR, 13%–55%]) >Ttm cells (6% [IQR, 0%–42%]) >Tem cells (3% [IQR, 0.005%–21%]). (B) Contribution of T cell subsets to the intact reservoir of ECs (n = 4). Naive T cells did not contain any intact HIV sequence. Ttm cells were the major contributor to intact HIV in ECs (86% [IQR, 32%–98%]). No intact HIV sequences were found in Tcm cells and Tem cells of 2 ECs (gray symbols). EC1 was excluded because we did not retrieve any intact HIV sequence. The contribution of each subset to the intact reservoir was calculated using the following formula: [(levels of HIV DNA within subset) × (% intact HIV within subset) × (subset/μL/total CD4/μL)]. Lines represent median values. ART, antiretroviral therapy; CPs, chronic progressors; ECs, elite controllers; naive T cells, naive CD4+ T cells; Tcm, central memory CD4+ T cells; Ttm, transitional memory CD4+ T cells; Tem, effector memory CD4+ T cells.

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