HIV preferentially infects HIV-specific CD4⁺ T cells

HIV infection is associated with the progressive loss of CD4⁺T cells through their destruction or decreased production. A central, yet unresolved issue of HIV disease is the mechanism for this loss, and in particular whether HIV-specific CD4⁺ T cells are preferentially affected. Here we show that HIV-specific memory CD4⁺ T cells in infected individuals contain more HIV viral DNA than other memory CD4⁺ T cells, at all stages of HIV disease. Additionally, following viral rebound during interruption of antiretroviral therapy, the frequency of HIV viral DNA in the HIV-specific pool of memory CD4⁺ T cells increases to a greater extent than in memory CD4⁺ T cells of other specificities. These findings show that HIV-specific CD4⁺ T cells are preferentially infected by HIV in vivo. This provides a potential mechanism to explain the loss of HIV-specific CD4⁺ T-cell responses, and consequently the loss of immunological control of HIV replication. Furthermore, the phenomenon of HIV specifically infecting the very cells that respond to it adds a cautionary note to the practice of structured therapy interruption.