Relationship between residual plasma viremia and the size of HIV proviral DNA reservoirs in infected individuals receiving effective antiretroviral therapy

Abstract

Residual plasma viremia (<50 copies/mL) persists in certain human immunodeficiency virus (HIV)-infected individuals receiving antiretroviral therapy (ART); however, the relationship between the degree of residual plasma viremia, the size of HIV reservoirs, and the level of immune activation has not been delineated. Here, we demonstrate that residual plasma viremia correlates with the size of the CD4(+) T cell viral reservoir, but not with markers of immune activation, suggesting that reactivation of the latent viral reservoir may not be the sole source of residual plasma viremia. Novel therapeutic strategies aimed at targeting the source of residual viremia may be necessary to achieve viral eradication.

Figure 1.

Relationship between residual plasma viremia and human immunodeficiency virus (HIV) proviral DNA in CD4⁺ T cells of HIV-infected individuals receiving antiretroviral therapy (ART) for prolonged periods of time. A, Distribution of residual plasma viremia in individuals with <50 HIV RNA copies/mL plasma. B, relationship between residual plasma viremia and cell-associated HIV DNA. C, frequencies of CD4⁺ T cells carrying HIV proviral DNA based on plasma viremia. The open and closed circles represent undetectable and detectable values, respectively, determined by quadruplicate measurements. When quadruplicates of plasma samples were negative for HIV RNA, they were scored as undetectable (ie, below the limit of detection). The median value is shown as gray bars.