Expanded cellular clones carrying replication-competent HIV-1 persist, wax, and wane

Abstract

Significance The HIV-1 latent reservoir cannot be eradicated by antiretroviral therapy (ART). The reservoir is a major barrier to cure. To characterize the mechanisms that contribute to persistence of the latent reservoir, we examined clonally expanded cell populations carrying replication-competent HIV-1 and followed them longitudinally. Expanded clones harboring replication-competent HIV-1 were identified in all study participants, but these clones emerge and wane on a time scale of years. A similar pattern was identified in viruses sampled from residual viremia. The findings suggest that the latent reservoir is likely to be maintained through expansion driven by antigens and cytokines, and that the expansion is balanced with a constant cell loss.