Journal
CELL
Volume 155, Issue 3, Pages 540-551Publisher
CELL PRESS
DOI: 10.1016/j.cell.2013.09.020
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Funding
- amfAR as part of the amfAR Research Collaboration on HIV Eradication (ARCHE)
- Martin Delaney CARE and DARE Collaboratories (National Institutes of Health [NIH] [AI096113, AI096109]
- NIH [AI043222]
- Johns Hopkins Center for AIDS Research
- Howard Hughes Medical Institute
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Antiretroviral therapy fails to cure HIV-1 infection because latent proviruses persist in resting CD4(+) T cells. T cell activation reverses latency, but <1% of proviruses are induced to release infectious virus after maximum in vitro activation. The noninduced proviruses are generally considered defective but have not been characterized. Analysis of 213 noninduced proviral clones from treated patients showed 88.3% with identifiable defects but 11.7% with intact genomes and normal long terminal repeat (LTR) function. Using direct sequencing and genome synthesis, we reconstructed full-length intact noninduced proviral clones and demonstrated growth kinetics comparable to reconstructed induced proviruses from the same patients. Noninduced proviruses have unmethylated promoters and are integrated into active transcription units. Thus, it cannot be excluded that they may become activated in vivo. The identification of replication-competent noninduced proviruses indicates that the size of the latent reservoir-and, hence, the barrier to cure-may be up to 60-fold greater than previously estimated.
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