
handle: 2123/31281
Antiretroviral therapy (ART) effectively suppresses HIV-1 replication. However, HIV-1 rebounds when ART is interrupted due to the persistence of HIV-1 proviruses in CD4+ T cells during suppressive ART. We performed an extensive genetic characterisation of HIV-1 to investigate the cellular and viral mechanisms contributing to this viral rebound. First, we used the full-length individual proviral sequencing (FLIPS) assay to investigate the HIV-1 proviruses that persist in memory CD4+ T cells sorted into 4 cell subsets based on the expression of the immune checkpoint markers programmed cell death protein-1 (PD-1) and/or cytotoxic T-lymphocyte-associated protein-4 (CTLA-4). We found that during long-term ART, memory CD4+ T cells that express PD-1, rather than those that express CTLA-4, have characteristics, such as increased cellular proliferation, that allow the persistence of HIV-1 proviruses. However, we identified considerable participant-specific variation in the enrichment of HIV-1 proviruses within CD4+ T cells expressing PD-1 and/or CTLA-4. Next, we presented a novel assay for genetically characterising near-full-length HIV-1 RNA genomes from the plasma of viremic individuals living with HIV-1, called the plasma-derived HIV-1 RNA using long-range sequencing (PRLS) assay. We used this assay to demonstrate that a considerable proportion of HIV-1 virions during untreated HIV-1 infection contain genetically-defective genomes. Then, we employed the PRLS assay to genetically characterise HIV-1 RNA genomes from rebound viral variants in 5 individuals undergoing 3 analytical treatment interruptions (ATIs). We found an association between the emergence of genetically distinct viral variants during an ATI and a delayed time to viral rebound. These findings increase our knowledge of the mechanisms behind HIV-1 rebound when ART is interrupted, and contributes to the identification of possible therapeutic strategies to prevent this viral rebound in the absence of ART.
ART interruption, 570, HIV viral rebound, HIV, HIV persistence
ART interruption, 570, HIV viral rebound, HIV, HIV persistence
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