JOURNAL OF CLINICAL INVESTIGATION

Mitchell JL, Takata H, Muir R, Colby DJ, Kroon E, Crowell TA, Sacdalan C, Pinyakorn S, Pattamaswin S, Benjapornpong K, Trichavaroj R, Tressler RL, Fox L, Polonis VR, Bolton DL, Maldarelli F, Lewin SR, Haddad EK, Phanuphak P, Robb ML, Michael NL, de Souza M, Phanuphak N, Ananworanich J and Trautmann L

J Clin Invest. 2020.

DOI: 10.1172/JCI130597

Abstract

Plasmacytoid dendritic cells (pDCs) are robust producers of interferon α (IFNα) and one of the first immune cells to respond to simian immunodeficiency virus infection. To elucidate responses to early HIV-1 replication, we studied blood pDCs in 29 HIV-infected participants who initiated antiretroviral therapy during acute infection and underwent analytic treatment interruption (ATI). An increased frequency of partially activated pDCs was observed in the blood prior to detection of HIV RNA. Concurrent with peak pDC frequency, there was a transient decline in the ability of pDCs to produce IFNα in vitro, which correlated with decreased interferon regulatory factory 7 (IRF7) and NF-kB phosphorylation. Levels of phosphorylated IRF7 and NF-kB inversely correlated with plasma IFNα2 levels, implying that pDCs were refractory to in vitro stimulation after IFNα production in vivo. After ATI, decreased expression of IFN genes in pDCs inversely correlated with time to viral detection, suggesting that pDC IFN loss is part of an effective early immune response. These data, from a limited cohort, provide a critical first step in understanding the earliest immune response to HIV-1 and suggest that changes in blood pDC frequency and function can be used as an indicator of viral replication before detectable plasma viremia.