BACKGROUND : Identification of all possible HIV reservoirs is an important aspect in HIV eradication efforts. The urinary
tract has however not been well studied as a potential HIV reservoir. In this pilot study we molecularly characterized
HIV-1 viruses in urine and plasma samples to investigate HIV-1 replication, compartmentalization and persistence in
the urinary tract.
METHODS : Prospectively collected urine and blood samples collected over 12–36 months from 20 HIV-1 infected
individuals were analysed including sampling points from prior to and after ART initiation. HIV-1 pol gene RNA and
DNA from urine supernatant and urine pellets respectively were analysed and compared to plasma RNA viruses from
the same individual.
RESULTS : HIV-1 nucleic acid was detected in urine samples from at least one time point in 8/20 (40%) treatment-naïve
subjects compared to 1/13 (7.7%) individuals on antiretroviral treatment (ART) during periods of plasma viral suppression
and 1/7 (14.3%) individuals with virological failure. HIV-1 RNA was undetectable in urine samples after ART
initiation but HIV-1 DNA was detectable in one patient more than 6 months after treatment initiation. There was coclustering
of urine-derived pol sequences but some urine-derived sequences were interspersed among the plasmaderived
sequences.
CONCLUSIONS : Suppressive ART reduces HIV-1 replication in the urinary tract but HIV-1 DNA may persist in these cells
despite treatment. A larger number of sequences would be required to confirm HIV compartmentalization in the
urinary tract.
Description:
Table S1. Study subjects and time points at which urine
samples were tested.
