AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA.
AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
J Virol. 2019 Dec 12;94(1). doi: 10.1128/JVI.01308-19.
The major obstacle to more-definitive treatment for HIV infection is the early establishment of virus that persists despite long-term combination antiretroviral therapy (cART) and can cause recrudescent viremia if cART is interrupted. Previous studies of HIV DNA that persists despite cART indicated that only a small fraction of persistent viral sequences was intact. Experimental simian immunodeficiency virus (SIV) infections of nonhuman primates (NHPs) are essential models for testing interventions designed to reduce the viral reservoir. We studied the viral genomic integrity of virus that persists during cART under conditions typical of many NHP reservoir studies, specifically with cART started within 1 year postinfection and continued for at least 9 months. The fraction of persistent DNA in SIV-infected NHPs starting cART during acute or chronic infection was assessed with a multiamplicon, real-time PCR assay designed to analyze locations that are regularly spaced across the viral genome to maximize coverage (collectively referred to as "tile assay") combined with near-full-length (nFL) single-genome sequencing. The tile assay is used to rapidly screen for major deletions, with nFL sequence analysis used to identify additional potentially inactivating mutations. Peripheral blood mononuclear cells (PBMC) from animals started on cART within 1 month of infection, sampled at least 9 months after cART initiation, contained at least 80% intact genomes, whereas those from animals started on cART 1 year postinfection and treated for 1 year contained intact genomes only 47% of the time. The most common defect identified was large deletions, with the remaining defects caused by APOBEC-mediated mutations, frameshift mutations, and inactivating point mutations. Overall, this approach can be used to assess the intactness of persistent viral DNA in NHPs. Molecularly defining the viral reservoir that persists despite antiretroviral therapy and that can lead to rebound viremia if antiviral therapy is removed is critical for testing interventions aimed at reducing this reservoir. In HIV infection in humans with delayed treatment initiation and extended treatment duration, persistent viral DNA has been shown to be dominated by nonfunctional genomes. Using multiple real-time PCR assays across the genome combined with near-full-genome sequencing, we defined SIV genetic integrity after 9 to 18 months of combination antiretroviral therapy in rhesus macaques starting therapy within 1 year of infection. In the animals starting therapy within a month of infection, the vast majority of persistent DNA was intact and presumptively functional. Starting therapy within 1 year increased the nonintact fraction of persistent viral DNA. The approach described here allows rapid screening of viral intactness and is a valuable tool for assessing the efficacy of novel reservoir-reducing interventions.
尽管长期接受联合抗逆转录病毒疗法 (cART),但 HIV 感染的更明确治疗的主要障碍是早期建立的病毒持续存在,并且如果中断 cART,可能会导致病毒血症复发。先前对 cART 持续存在的 HIV DNA 的研究表明,只有一小部分持续的病毒序列是完整的。用非人类灵长类动物 (NHP) 进行实验性猴免疫缺陷病毒 (SIV) 感染是测试旨在减少病毒库的干预措施的重要模型。我们研究了在许多 NHP 储库研究中典型的情况下,即在感染后 1 年内开始 cART 并至少持续 9 个月的情况下,cART 期间持续存在的病毒的基因组完整性。用多扩增子、实时 PCR 测定法评估急性或慢性感染期间开始 cART 的 SIV 感染 NHP 中持续 DNA 的比例,该测定法设计用于分析在病毒基因组中均匀间隔的位置,以最大限度地覆盖(统称为“瓷砖测定法”),并结合近全长 (nFL) 单基因组测序。瓷砖测定法用于快速筛选主要缺失,nFL 序列分析用于鉴定其他潜在的失活突变。在感染后 1 个月内开始 cART 的动物的外周血单核细胞 (PBMC),在 cART 开始至少 9 个月后采样,至少含有 80%完整的基因组,而在感染后 1 年开始 cART 并治疗 1 年的动物中,只有 47%的时间含有完整的基因组。鉴定出的最常见缺陷是大片段缺失,其余缺陷是由 APOBEC 介导的突变、移码突变和失活点突变引起的。总的来说,这种方法可用于评估 NHP 中持续存在的病毒 DNA 的完整性。定义尽管存在抗逆转录病毒疗法但仍能持续存在并在去除抗病毒治疗后可导致病毒血症复发的病毒库,对于测试旨在减少该库的干预措施至关重要。在人类中延迟治疗开始和延长治疗时间的 HIV 感染中,已经表明持续存在的病毒 DNA 主要由无功能基因组组成。我们使用全基因组的多个实时 PCR 测定法结合近全长基因组测序,定义了在感染后 1 年内开始治疗的恒河猴接受联合抗逆转录病毒治疗 9 至 18 个月后的 SIV 遗传完整性。在感染后 1 个月内开始治疗的动物中,绝大多数持续 DNA 是完整的,并且推测是功能性的。在感染后 1 年内开始治疗会增加持续存在的病毒 DNA 的非完整部分。此处描述的方法允许快速筛选病毒完整性,是评估新型库减少干预措施的有效性的有价值的工具。
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