Figure 2.
Episodic asymptomatic CSF escape variants are most likely produced by clonally expanded CD4+ T cells present in the CNS during ART (participant 3025). A, HIV-1 viral loads in the plasma (values connected by a red line) and CSF (values connected by a blue line) were measured at multiple time points for participant 3025. CSF escape was observed after 19 months of ART but was undetectable at 27 months post-ART. A MiSeq with Primer ID approach was used to generate partial env sequences from the CSF escape population (blue dot). ART regimen is shown in the gray box. B, A neighbor-joining phylogenetic tree of 733 partial env sequences illustrates that the CSF escape population was nearly homogeneous. C, A full-length HIV-1 env cloned from this homogeneous population was pseudotyped and shown to be T cell-tropic in a CD4lowCCR5high Affinofile entry assay. Abbreviations: ART, antiretroviral therapy; CSF, cerebrospinal fluid; DRV/r, ritonavir-boosted darunavir; FTC, emtricitabine; HIV, human immunodeficiency virus; TDF, tenofovir disoproxil fumarate.