Longitudinal study of HIV-1-infected CD4+ T cell dynamics during long-term antiretroviral therapy

Clonal proliferation of CD4+ T cells harboring HIV-1 proviruses is a major contributor to viral persistence in people on antiretroviral therapy (ART). We conducted a longitudinal study to determine whether CTL pressure or differential rates of clonal proliferation shape the HIV-1 provirus landscape in people on suppressive ART. In order to magnify what might be small effects, we obtained samples from widely separated timepoints (average 7 years) in 8 people who had consistently undetectable viral loads over many years on ART. Given that controllers have particularly strong HIV-specific CTL responses, we included 3 controllers on ART in our study. This study will help us understand the drivers of viral persistence in treated HIV patients. Such knowledge is fundamental to the HIV cure effort.