[HTML][HTML] The forces driving clonal expansion of the HIV-1 latent reservoir

R Liu, FR Simonetti, YC Ho - Virology journal, 2020 - Springer
Virology journal, 2020Springer
Despite antiretroviral therapy (ART) which halts HIV-1 replication and reduces plasma viral
load to clinically undetectable levels, viral rebound inevitably occurs once ART is
interrupted. HIV-1-infected cells can undergo clonal expansion, and these clonally
expanded cells increase over time. Over 50% of latent reservoirs are maintained through
clonal expansion. The clonally expanding HIV-1-infected cells, both in the blood and in the
lymphoid tissues, contribute to viral rebound. The major drivers of clonal expansion of HIV-1 …
Abstract
Despite antiretroviral therapy (ART) which halts HIV-1 replication and reduces plasma viral load to clinically undetectable levels, viral rebound inevitably occurs once ART is interrupted. HIV-1-infected cells can undergo clonal expansion, and these clonally expanded cells increase over time. Over 50% of latent reservoirs are maintained through clonal expansion. The clonally expanding HIV-1-infected cells, both in the blood and in the lymphoid tissues, contribute to viral rebound. The major drivers of clonal expansion of HIV-1-infected cells include antigen-driven proliferation, homeostatic proliferation and HIV-1 integration site-dependent proliferation. Here, we reviewed how viral, immunologic and genomic factors contribute to clonal expansion of HIV-1-infected cells, and how clonal expansion shapes the HIV-1 latent reservoir. Antigen-specific CD4+ T cells specific for different pathogens have different clonal expansion dynamics, depending on antigen exposure, cytokine profiles and exhaustion phenotypes. Homeostatic proliferation replenishes the HIV-1 latent reservoir without inducing viral expression and immune clearance. Integration site-dependent proliferation, a mechanism also deployed by other retroviruses, leads to slow but steady increase of HIV-1-infected cells harboring HIV-1 proviruses integrated in the same orientation at specific sites of certain cancer-related genes. Targeting clonally expanding HIV-1 latent reservoir without disrupting CD4+ T cell function is a top priority for HIV-1 eradication.
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