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T cell derived HIV-1 is present in the CSF in the face of suppressive antiretroviral therapy

Lustig, G; Cele, S; Karim, F; Derache, A; Ngoepe, A; Khan, K; Gosnell, BI; ... Sigal, A; + view all (2021) T cell derived HIV-1 is present in the CSF in the face of suppressive antiretroviral therapy. PLOS Pathogens , 17 (9) , Article e1009871. 10.1371/journal.ppat.1009871. Green open access

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Abstract

HIV cerebrospinal fluid (CSF) escape, where HIV is suppressed in blood but detectable in CSF, occurs when HIV persists in the CNS despite antiretroviral therapy (ART). To determine the virus producing cell type and whether lowered CSF ART levels are responsible for CSF escape, we collected blood and CSF from 156 neurosymptomatic participants from Durban, South Africa. We observed that 28% of participants with an undetectable HIV blood viral load showed CSF escape. We detected host cell surface markers on the HIV envelope to determine the cellular source of HIV in participants on the first line regimen of efavirenz, emtricitabine, and tenofovir. We confirmed CD26 as a marker which could differentiate between T cells and macrophages and microglia, and quantified CD26 levels on the virion surface, comparing the result to virus from in vitro infected T cells or macrophages. The measured CD26 level was consistent with the presence of T cell produced virus. We found no significant differences in ART concentrations between CSF escape and fully suppressed individuals in CSF or blood, and did not observe a clear association with drug resistance mutations in CSF virus which would allow HIV to replicate. Hence, CSF HIV in the face of ART may at least partly originate in CD4+ T cell populations.

Type: Article
Title: T cell derived HIV-1 is present in the CSF in the face of suppressive antiretroviral therapy
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.ppat.1009871
Publisher version: https://doi.org/10.1371/journal.ppat.1009871
Language: English
Additional information: Copyright © 2021 Lustig et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Cerebrospinal fluid, HIV, Macrophages, Virions, Blood, Microglial cells, Viral load, Antiretroviral therapy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10135989
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