Compartmentalized Human Immunodeficiency Virus Type 1 Reservoir in Intestinal Monocytes/Macrophages on Antiretroviral Therapy.

This article focuses on the characterization of the human immunodeficiency virus type 1 (HIV-1) reservoir in intestinal monocytes/macrophages (Mo/Mϕ) compared to CD4+ T cells in people with HIV (PWH) on suppressive antiretroviral therapy (ART). The study found that intestinal Mo/Mϕ harbor HIV-1 DNA, including intact and unintegrated proviruses, but at levels approximately 300-fold lower than in CD4+ T cells, with evidence of viral compartmentalization between these cell types in some individuals. Phenotypic analyses of HIV-1 envelope proteins from colonic Mo/Mϕ revealed T-cell tropism rather than macrophage tropism, suggesting that intestinal macrophages may be infected through mechanisms distinct from classical macrophage-tropic viral entry. These findings highlight the complexity of HIV-1 persistence in the gut and underscore the need to further investigate the role and infection pathways of intestinal macrophages in HIV-1 reservoirs during ART.