HIV Reservoirs and Viral Turnover

The virus detected in patients' blood is produced mostly by short-lived infected CD4+ T cells and in smaller amounts by other infected cells. Three phases of decay of plasma viremia have been observed in patients treated with anti-retroviral drugs or predicted by mathematical modeling, and these decay curves have been used to surmise the distribution of HIV in different cellular reservoirs. More than 90% of plasma virus is believed to be produced by short-lived cells (half-lives of ~1 day), which are most likely activated CD4+ T cells that are major reservoirs and sources of the virus in infected patients. About 5% of plasma virus is produced by macrophages, which have a slower turnover (half-life of about 2 weeks). It is hypothesized that a small fraction of the virus, perhaps as little as 1%, is present in latently infected memory T cells. Because of the long life span of memory cells, it could take decades for this reservoir of virus to be eliminated even if all new rounds of infection were blocked.

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