Figure 3.

The source of asymptomatic CSF escape in a poorly suppressed participant is unclear (participant 340). 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 340. Nongray dots indicate the time point at which viral RNA was extracted from plasma and/or CSF, and single-genome amplification (SGA) was used to generate full-length env genes. Antiretroviral therapy regimen is shown in the gray box. B, A neighbor-joining phylogenetic tree of full-length env sequences illustrates that identical sequences are found in the CSF and blood plasma. C, Full-length HIV-1 envs cloned from the CSF population were pseudotyped and shown to be T cell-tropic based on an inability to efficiently enter Affinofile cells expressing a low surface density of CD4. Abbreviations: ART, antiretroviral therapy; CSF, cerebrospinal fluid; DRV/r, ritonavir-boosted darunavir; FTC, emtricitabine; HIV, human immunodeficiency virus; TDF, tenofovir disoproxil fumarate.