title: Primary and recombinant HIV type 1 strains resistant to protease inhibitors are pathogenic in mature human lymphoid tissues.
abstract: Preserved peripheral CD4+ T cell counts despite virologic failure in patients undergoing protease inhibitor (PI)-containing antiviral regimens are a frequent occurrence in human immunodeficiency virus (HIV) disease. One hypothesis to explain the relative sparing of CD4+ T cells is that HIV strains exhibiting PI resistance concomitantly are attenuated in terms of cytopathicity for mature T cells. To test this hypothesis, we used a three-dimensional human tonsil histoculture microenvironment to assess the pathogenic potential of a panel of primary and recombinant HIV-1 strains derived from patients experiencing PI failure. All the viruses tested replicated efficiently in these cultures and, in some cases, better than comparable wild-type viral isolates. Furthermore, the PI-resistant strains depleted CD4+ T cells potently and comparably with wild-type isolates in these ex vivo lymphoid tissues. These results demonstrate that PI-resistant viruses are not inherently less pathogenic for mature T cells. Therefore, the sustained peripheral lymphocyte counts in patients with selective virologic failure may be due to specific defects in viral replication in other cell compartments or to an undefined host adaptation to viral infection during PI therapy.
authors.affiliation: Gladstone Institute of Virology and Immunology, University of California San Francisco, San Francisco, CA 94141, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Penn
authors.forename: M
authors.initials: M
authors.lastname: Myers
authors.forename: D A
authors.initials: DA
authors.lastname: Eckstein
authors.forename: T J
authors.initials: TJ
authors.lastname: Liegler
authors.forename: M
authors.initials: M
authors.lastname: Hayden
authors.forename: F
authors.initials: F
authors.lastname: Mammano
authors.forename: F
authors.initials: F
authors.lastname: Clavel
authors.forename: S G
authors.initials: SG
authors.lastname: Deeks
authors.forename: R M
authors.initials: RM
authors.lastname: Grant
authors.forename: M A
authors.initials: MA
authors.lastname: Goldsmith
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology / Q000821:virology; D046508:Culture Techniques; D003588:Cytopathogenic Effect, Viral; D004352:Drug Resistance, Microbial; D015658:HIV Infections / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000821:virology*; D016333:HIV Protease / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000494:pharmacology*; D015497:HIV-1 / Q000187:drug effects / Q000472:pathogenicity*; D006801:Humans; D008212:Lymphocyte Depletion; D008221:Lymphoid Tissue; D014066:Palatine Tonsil / Q000821:virology; D011995:Recombination, Genetic
chemical_list: D017320:HIV Protease Inhibitors; D016333:HIV Protease