title: Analysis of human immunodeficiency virus type 1 viremia and provirus in resting CD4+ T cells reveals a novel source of residual viremia in patients on antiretroviral therapy.
abstract: Highly active antiretroviral therapy (HAART) can reduce human immunodeficiency virus type 1 (HIV-1) viremia to clinically undetectable levels. Despite this dramatic reduction, some virus is present in the blood. In addition, a long-lived latent reservoir for HIV-1 exists in resting memory CD4(+) T cells. This reservoir is believed to be a source of the residual viremia and is the focus of eradication efforts. Here, we use two measures of population structure--analysis of molecular variance and the Slatkin-Maddison test--to demonstrate that the residual viremia is genetically distinct from proviruses in resting CD4(+) T cells but that proviruses in resting and activated CD4(+) T cells belong to a single population. Residual viremia is genetically distinct from proviruses in activated CD4(+) T cells, monocytes, and unfractionated peripheral blood mononuclear cells. The finding that some of the residual viremia in patients on HAART stems from an unidentified cellular source other than CD4(+) T cells has implications for eradication efforts.
authors.affiliation: Department of Molecular Biology and Genetics, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Brennan
authors.forename: John O
authors.initials: JO
authors.lastname: Woods
authors.forename: Ahmad R
authors.initials: AR
authors.lastname: Sedaghat
authors.forename: Janet D
authors.initials: JD
authors.lastname: Siliciano
authors.forename: Robert F
authors.initials: RF
authors.lastname: Siliciano
authors.forename: Claus O
authors.initials: CO
authors.lastname: Wilke
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000821:virology*; D016000:Cluster Analysis; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008969:Molecular Sequence Data; D011110:Polymorphism, Genetic; D011533:Proviruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D014766:Viremia
chemical_list: D019380:Anti-HIV Agents