CD32+ and PD-1+ Lymph Node CD4 T Cells Support Persistent HIV-1 Transcription in Treated Aviremic Individuals

A recent study conducted in blood has proposed CD32 as the marker identifying the 9elusive9 HIV reservoir. We have investigated the distribution of CD32+ CD4 T cells in blood and lymph nodes (LNs) of healthy HIV-1 uninfected, viremic untreated and long-term treated HIV-1 infected individuals and their relationship with PD-1+ CD4 T cells. The frequency of CD32+ CD4 T cells was increased in viremic as compared to treated individuals in LNs and a large proportion (up to 50%) of CD32+ cells co-expressed PD-1 and were enriched within T follicular helper cells (Tfh) cells. We next investigated the role of LN CD32+ CD4 T cells in the HIV reservoir. Total HIV DNA was enriched in CD32+ and PD-1+ CD4 T cells as compared to CD32- and PD-1- cells in both viremic and treated individuals but there was no difference between CD32+ and PD-1+ cells. There was not enrichment of latently infected cells with inducible HIV-1 in CD32+ versus PD-1+ cells in ART treated individuals. HIV-1 transcription was then analyzed in LN memory CD4 T cell populations sorted on the basis of CD32 and PD-1 expression. CD32+PD-1+ CD4 T cells were significantly enriched in cell associated HIV RNA as compared to CD32-PD-1- (average 5.2 fold in treated and 86.6 fold in viremics), to CD32+PD-1- (2.2 fold in treated and 4.3 fold in viremics) and to CD32-PD-1+ cell populations (2.2 fold in ART treated and 4.6 fold in viremics). Similar levels of HIV-1 transcription were found in CD32+PD-1- and CD32-PD-1+ CD4 T cells. Interestingly, the proportion of CD32+ and PD-1+ CD4 T cells negatively correlated with CD4 T cell counts and length of therapy while positively correlated with viremia. Therefore, the expression of CD32 identifies, independently of PD-1, a CD4 T cell population with persistent HIV-1 transcription and CD32 and PD-1 co-expression the CD4 T cell population with the highest levels of HIV-1 transcription in both viremic and treated individuals.