Dynamics and origin of rebound viremia in SHIV-infected infant macaques following interruption of long-term ART.

TitleDynamics and origin of rebound viremia in SHIV-infected infant macaques following interruption of long-term ART.
Publication TypeJournal Article
Year of Publication2021
AuthorsObregon-Perko V, Bricker KM, Mensah G, Uddin F, Rotolo L, Vanover D, Desai Y, Santangelo PJ, Jean S, Wood JS, Connor-Stroud FC, Ehnert S, Berendam SJ, Liang S, Vanderford TH, Bar KJ, Shaw GM, Silvestri G, Kumar A, Fouda GG, Permar SR, Chahroudi A
JournalJCI Insight
Volume6
Issue23
Date Published2021 Dec 08
ISSN2379-3708
KeywordsAnimals, Anti-Retroviral Agents, Female, Macaca, Male, Simian Acquired Immunodeficiency Syndrome, Viremia
Abstract

Understanding viral rebound in pediatric HIV-1 infection may inform the development of alternatives to lifelong antiretroviral therapy (ART) to achieve viral remission. We thus investigated viral rebound after analytical treatment interruption (ATI) in 10 infant macaques orally infected with SHIV.C.CH505 and treated with long-term ART. Rebound viremia was detected within 7 to 35 days of ATI in 9 of 10 animals, with posttreatment control of viremia seen in 5 of 5 Mamu-A*01+ macaques. Single-genome sequencing revealed that initial rebound virus was similar to viral DNA present in CD4+ T cells from blood, rectum, and lymph nodes before ATI. We assessed the earliest sites of viral reactivation immediately following ATI using ImmunoPET imaging. The largest increase in signal that preceded detectable viral RNA in plasma was found in the gastrointestinal (GI) tract, a site with relatively high SHIV RNA/DNA ratios in CD4+ T cells before ATI. Thus, the GI tract may be an initial source of rebound virus, but as ATI progresses, viral reactivation in other tissues likely contributes to the composition of plasma virus. Our study provides potentially novel insight into the features of viral rebound in pediatric infection and highlights the application of a noninvasive technique to monitor areas of HIV-1 expression in children.

DOI10.1172/jci.insight.152526
Alternate JournalJCI Insight
PubMed ID34699383
PubMed Central IDPMC8675190
Grant ListT32 AI007392 / AI / NIAID NIH HHS / United States
P30 AI050409 / AI / NIAID NIH HHS / United States
P51 OD011132 / OD / NIH HHS / United States
T32 AI074492 / AI / NIAID NIH HHS / United States
P01 AI131251 / AI / NIAID NIH HHS / United States
R01 AI165080 / AI / NIAID NIH HHS / United States
R01 AI118549 / AI / NIAID NIH HHS / United States
P01 AI131276 / AI / NIAID NIH HHS / United States
U42 OD011023 / OD / NIH HHS / United States
UM1 AI164566 / AI / NIAID NIH HHS / United States