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      Directly Infected Resting CD4+T Cells Can Produce HIV Gag without Spreading Infection in a Model of HIV Latency

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          Abstract

          Despite the effectiveness of highly active antiretroviral therapy (HAART) in treating individuals infected with HIV, HAART is not a cure. A latent reservoir, composed mainly of resting CD4+T cells, drives viral rebound once therapy is stopped. Understanding the formation and maintenance of latently infected cells could provide clues to eradicating this reservoir. However, there have been discrepancies regarding the susceptibility of resting cells to HIV infection in vitro and in vivo. As we have previously shown that resting CD4+T cells are susceptible to HIV integration, we asked whether these cells were capable of producing viral proteins and if so, why resting cells were incapable of supporting productive infection. To answer this question, we spinoculated resting CD4+T cells with or without prior stimulation, and measured integration, transcription, and translation of viral proteins. We found that resting cells were capable of producing HIV Gag without supporting spreading infection. This block corresponded with low HIV envelope levels both at the level of protein and RNA and was not an artifact of spinoculation. The defect was reversed upon stimulation with IL-7 or CD3/28 beads. Thus, a population of latent cells can produce viral proteins without resulting in spreading infection. These results have implications for therapies targeting the latent reservoir and suggest that some latent cells could be cleared by a robust immune response.

          Author Summary

          While HIV is a treatable disease due to effective antiviral therapies, these drugs do not cure HIV. When therapy is stopped, a pool of infected, long-lived, treatment resistant cells re-establishes infection. These latently infected cells, mainly resting CD4+T cells, are barriers to a cure. Studying and understanding the properties of these cells is therefore important to eradicating HIV. It is believed that these latent cells do not produce viral proteins and thus are invisible to the immune system. Here, we show using an in vitro HIV model that a population of latently infected cells can produce HIV Gag. Interestingly, this protein production does not result in the release of detectable infectious virus and so the latent cells are unaffected by antiviral therapy. We therefore examined why some latent cells can produce viral proteins without viral spread. We found that resting cells have the ability to make some of the components required for spreading infection but not all are in sufficient quantity. These results have important implications for treating the latent reservoir, as our work suggests that latent cells might be recognized by a boosted immune response.

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          Most cited references55

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          Quantification of latent tissue reservoirs and total body viral load in HIV-1 infection.

          The capacity of HIV-1 to establish latent infection of CD4+ T cells may allow viral persistence despite immune responses and antiretroviral therapy. Measurements of infectious virus and viral RNA in plasma and of infectious virus, viral DNA and viral messenger RNA species in infected cells all suggest that HIV-1 replication continues throughout the course of infection. Uncertainty remains over what fraction of CD4+ T cells are infected and whether there are latent reservoirs for the virus. We show here that during the asymptomatic phase of infection there is an extremely low total body load of latently infected resting CD4+ T cells with replication-competent integrated provirus (<10(7) cells). The most prevalent form of HIV-1 DNA in resting and activated CD4+ T cells is a full-length, linear, unintegrated form that is not replication competent. The infection progresses even though at any given time in the lymphoid tissues integrated HIV-1 DNA is present in only a minute fraction of the susceptible populations, including resting and activated CD4+ T cells and macrophages.
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            HIV reproducibly establishes a latent infection after acute infection of T cells in vitro.

            The presence of latent reservoirs has prevented the eradication of human immunodeficiency virus (HIV) from infected patients successfully treated with anti-retroviral therapy. The mechanism of postintegration latency is poorly understood, partly because of the lack of an in vitro model. We have used an HIV retroviral vector or a full-length HIV genome expressing green fluorescent protein to infect a T lymphocyte cell line in vitro and highly enrich for latently infected cells. HIV latency occurred reproducibly, albeit with low frequency, during an acute infection. Clonal cell lines derived from latent populations showed no detectable basal expression, but could be transcriptionally activated after treatment with phorbol esters or tumor necrosis factor alpha. Direct sequencing of integration sites demonstrated that latent clones frequently contain HIV integrated in or close to alphoid repeat elements in heterochromatin. This is in contrast to a productive infection where integration in or near heterochromatin is disfavored. These observations demonstrate that HIV can reproducibly establish a latent infection as a consequence of integration in or near heterochromatin.
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              Stimulation of HIV-1-specific cytolytic T lymphocytes facilitates elimination of latent viral reservoir after virus reactivation.

              Highly active antiretroviral therapy (HAART) suppresses HIV-1 replication but cannot eliminate the virus because HIV-1 establishes latent infection. Interruption of HAART leads to a rapid rebound of viremia, so life-long treatment is required. Efforts to purge the latent reservoir have focused on reactivating latent proviruses without inducing global T cell activation. However, the killing of the infected cells after virus reactivation, which is essential for elimination of the reservoir, has not been assessed. Here we show that after reversal of latency in an in vitro model, infected resting CD4(+) T cells survived despite viral cytopathic effects, even in the presence of autologous cytolytic T lymphocytes (CTLs) from most patients on HAART. Antigen-specific stimulation of patient CTLs led to efficient killing of infected cells. These results demonstrate that stimulating HIV-1-specific CTLs prior to reactivating latent HIV-1 may be essential for successful eradication efforts and should be considered in future clinical trials. Copyright © 2012 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Pathog
                PLoS Pathog
                plos
                plospath
                PLoS Pathogens
                Public Library of Science (San Francisco, USA )
                1553-7366
                1553-7374
                July 2012
                July 2012
                26 July 2012
                : 8
                : 7
                : e1002818
                Affiliations
                [1 ]Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
                [2 ]Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
                Emory University, United States of America
                Author notes

                Conceived and designed the experiments: MJP LMA EHG AMM TB FDB UO. Performed the experiments: MJP LMA EHG FM TB. Analyzed the data: MJP LMA TB FDB UO. Contributed reagents/materials/analysis tools: TB FDB. Wrote the paper: MJP LMA EHG AMM TB FDB UO.

                Article
                PPATHOGENS-D-12-00482
                10.1371/journal.ppat.1002818
                3406090
                22911005
                1dc8dc21-91fc-4531-80b9-930acb9fe5cd
                Pace et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 23 February 2012
                : 10 June 2012
                Page count
                Pages: 15
                Categories
                Research Article
                Medicine
                Infectious Diseases
                Viral Diseases
                HIV
                Retrovirology and HIV immunopathogenesis
                Infectious Disease Modeling

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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