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Recovery of replication-competent HIV despite prolonged suppression of plasma viremia

J K Wong1, M Hezareh, H F Günthard

  • 1Department of Medicine, University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA.

Science (New York, N.Y.)
|November 21, 1997
PubMed

Insights

Even with effective HIV treatment, latent virus can be isolated from patients. This study found active virus in cells despite undetectable plasma HIV RNA, indicating viral reservoirs persist.

Area of Science:

  • Virology
  • Immunology
  • Infectious Diseases

Background:

  • Current human immunodeficiency virus (HIV) combination drug regimens aim for viral suppression.
  • Understanding persistent viral reservoirs is crucial for eradicating HIV.
  • Latent HIV reservoirs can evade current therapeutic strategies.

Purpose of the Study:

  • To investigate the presence of latent HIV reservoirs in patients undergoing combination drug therapy.
  • To determine if viral reactivation can occur despite long-term plasma HIV RNA suppression.

Main Methods:

  • Peripheral blood mononuclear cells (PBMCs) were collected from HIV patients and normal donors.
  • CD8 cells were depleted from PBMCs.
  • Patient CD4 lymphocytes were activated using immobilized antibodies to CD3 and CD28.
  • Virus isolation from PBMCs was performed.
  • Partial sequencing of the HIV pol gene was conducted.

Main Results:

  • HIV was successfully isolated from PBMCs of six patients with plasma HIV RNA below 50 copies/mL for up to 2 years.
  • Partial sequencing of the HIV pol gene revealed no new drug resistance mutations.
  • No discernible viral evolution was observed in the sequenced pol gene fragments.

Conclusions:

  • The findings provide evidence for the existence of persistent, latent HIV reservoirs.
  • Viral latency, rather than drug failure, explains the isolation of virus from PBMCs.
  • These latent reservoirs pose a challenge for complete HIV eradication.

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