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Sci Transl Med. 2020 Mar 18;12(535). pii: eaat6263. doi: 10.1126/scitranslmed.aat6263.

Platelets from HIV-infected individuals on antiretroviral drug therapy with poor CD4+ T cell recovery can harbor replication-competent HIV despite viral suppression.

Author information

1
Mucosal Entry of HIV and Mucosal Immunity, Institut Cochin, Université de Paris, Paris, France.
2
INSERM U1016, Paris, France.
3
CNRS UMR8104, Paris, France.
4
Hôpital Ambroise Paré, Boulogne-Billancourt, France.
5
Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA.
6
Electron Microscopy Platform, Institut Cochin, Université de Paris, Paris, France.
7
Department of Internal Medicine, Hôpital Ambroise Paré, Boulogne, France.
8
CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Toulouse, France.
9
Department of Neuroscience, Cell Biology, and Anatomy, University of Texas Medical Branch (UTMB), Galveston, TX, USA.
10
INSERM U1043, Toulouse, France.
11
Université Toulouse III Paul-Sabatier, Faculté de Médecine Toulouse-Purpan, Toulouse, France.
12
CHU de Toulouse, Hôpital Purpan, Service des Maladies Infectieuses et Tropicales, Toulouse, France.
13
Mucosal Entry of HIV and Mucosal Immunity, Institut Cochin, Université de Paris, Paris, France. morgane.bomsel@inserm.fr.

Abstract

In addition to hemostasis, human platelets have several immune functions and interact with infectious pathogens including HIV in vitro. Here, we report that platelets from HIV-infected individuals on combined antiretroviral drug therapy (ART) with low blood CD4+ T cell counts (<350 cells/μl) contained replication-competent HIV despite viral suppression. In vitro, human platelets harboring HIV propagated the virus to macrophages, a process that could be prevented with the biologic abciximab, an anti-integrin αIIb/β3 Fab. Furthermore, in our cohort, 88% of HIV-infected individuals on ART with viral suppression and with platelets containing HIV were poor immunological responders with CD4+ T cell counts remaining below <350 cells/μl for more than one year. Our study suggests that platelets may be transient carriers of HIV and may provide an alternative pathway for HIV dissemination in HIV-infected individuals on ART with viral suppression and poor CD4+ T cell recovery.

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