Dynamics of HIV clonal expansion and persistence during ART

Authors

• EM Anderson
• S Hill
• J Bell
• FR Simonetti
• C Rehm
• S Jones
• R Gorelick
• M Kearney
• J Coffin
• F Maldarelli

Abstract

Despite the success of antiretroviral therapy (ART), HIV persists in most patients for years after ART initiation and rebounds upon treatment interruption. A stable HIV reservoir is the major barrier for an HIV cure. Furthermore, HIV infected cells can undergo clonal expansion and specific clones may be highly expanded. We previously reported one provirus integrated in the HORMAD2 gene that comprised ~20% of all proviruses in one patient. The mechanisms by which clones emerge and persist remain uncertain. Here, we developed multiplexed ddPCR approaches to quantify HIV proviruses, including specific integrants, prior to and following prolonged ART. 11 HIV-infected individuals underwent ART for a median of 13.7yrs. HIV DNA (gag and LTR) was quantified from PBMCs pre-ART, during viral decay, and after prolonged ART. All patients achieved viral suppression on ART to

Scientific Focus Area: Virology

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