- Clark, Iain C;
- Mudvari, Prakriti;
- Thaploo, Shravan;
- Smith, Samuel;
- Abu-Laban, Mohammad;
- Hamouda, Mehdi;
- Theberge, Marc;
- Shah, Sakshi;
- Ko, Sung Hee;
- Pérez, Liliana;
- Bunis, Daniel G;
- Lee, James S;
- Kilam, Divya;
- Zakaria, Saami;
- Choi, Sally;
- Darko, Samuel;
- Henry, Amy R;
- Wheeler, Michael A;
- Hoh, Rebecca;
- Butrus, Salwan;
- Deeks, Steven G;
- Quintana, Francisco J;
- Douek, Daniel C;
- Abate, Adam R;
- Boritz, Eli A
Rare CD4 T cells that contain HIV under antiretroviral therapy represent an important barrier to HIV cure1-3, but the infeasibility of isolating and characterizing these cells in their natural state has led to uncertainty about whether they possess distinctive attributes that HIV cure-directed therapies might exploit. Here we address this challenge using a microfluidic technology that isolates the transcriptomes of HIV-infected cells based solely on the detection of HIV DNA. HIV-DNA+ memory CD4 T cells in the blood from people receiving antiretroviral therapy showed inhibition of six transcriptomic pathways, including death receptor signalling, necroptosis signalling and antiproliferative Gα12/13 signalling. Moreover, two groups of genes identified by network co-expression analysis were significantly associated with HIV-DNA+ cells. These genes (n = 145) accounted for just 0.81% of the measured transcriptome and included negative regulators of HIV transcription that were higher in HIV-DNA+ cells, positive regulators of HIV transcription that were lower in HIV-DNA+ cells, and other genes involved in RNA processing, negative regulation of mRNA translation, and regulation of cell state and fate. These findings reveal that HIV-infected memory CD4 T cells under antiretroviral therapy are a distinctive population with host gene expression patterns that favour HIV silencing, cell survival and cell proliferation, with important implications for the development of HIV cure strategies.