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Cell-associated viral burden provides evidence of ongoing viral replication in aviremic HIV-2-infected patients


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Copyright © 2011, American Society for Microbiology. All Rights Reserved.

Viremia is significantly lower in HIV-2 than in HIV-1 infection, irrespective of disease stage. Nevertheless, the comparable proviral DNA burdens observed for these two infections indicate similar numbers of infected cells. Here we investigated this apparent paradox by assessing cell-associated viral replication. We found that untreated HIV-1-positive (HIV-1(+)) and HIV-2(+) individuals, matched for CD4 T cell depletion, exhibited similar gag mRNA levels, indicating that significant viral transcription is occurring in untreated HIV-2(+) patients, despite the reduced viremia (undetectable to 2.6 × 10(4) RNA copies/ml). However, tat mRNA transcripts were observed at significantly lower levels in HIV-2(+) patients, suggesting that the rate of de novo infection is decreased in these patients. Our data also reveal a direct relationship of gag and tat transcripts with CD4 and CD8 T cell activation, respectively. Antiretroviral therapy (ART)-treated HIV-2(+) patients showed persistent viral replication, irrespective of plasma viremia, possibly contributing to the emergence of drug resistance mutations, persistent hyperimmune activation, and poor CD4 T cell recovery that we observed with these individuals. In conclusion, we provide here evidence of significant ongoing viral replication in HIV-2(+) patients, further emphasizing the dichotomy between amount of plasma virus and cell-associated viral burden and stressing the need for antiretroviral trials and the definition of therapeutic guidelines for HIV-2 infection.

This study was funded by grants from Fundação para a Ciência e a Tecnologia (FCT) and Programa Operacional Ciência e Inovação 2010 (POCI2010), as well as from Fundação Calouste Gulbenkian, to A.E.S. A.P.B. received a scholarship from GlaxoSmithKline, and R.S.S., R.T., R.B.F., and R.C. a scholarship from FCT.

Document Type Journal article
Language English
Contributor(s) Repositório da Universidade de Lisboa
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