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CD8+ T cells fail to limit SIV reactivation following ART withdrawal until after viral amplification
Afam A. Okoye, Derick D. Duell, Yoshinori Fukazawa, Benjamin Varco-Merth, Alejandra Marenco, Hannah Behrens, Morgan Chaunzwa, Andrea N. Selseth, Roxanne M. Gilbride, Jason Shao, Paul T. Edlefsen, Romas Geleziunas, Mykola Pinkevych, Miles P. Davenport, Kathleen Busman-Sahay, Michael Nekorchuk, Haesun Park, Jeremy Smedley, Michael K. Axthelm, Jacob D. Estes, Scott G. Hansen, Brandon F. Keele, Jeffery D. Lifson, Louis J. Picker
Afam A. Okoye, Derick D. Duell, Yoshinori Fukazawa, Benjamin Varco-Merth, Alejandra Marenco, Hannah Behrens, Morgan Chaunzwa, Andrea N. Selseth, Roxanne M. Gilbride, Jason Shao, Paul T. Edlefsen, Romas Geleziunas, Mykola Pinkevych, Miles P. Davenport, Kathleen Busman-Sahay, Michael Nekorchuk, Haesun Park, Jeremy Smedley, Michael K. Axthelm, Jacob D. Estes, Scott G. Hansen, Brandon F. Keele, Jeffery D. Lifson, Louis J. Picker
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Research Article AIDS/HIV

CD8+ T cells fail to limit SIV reactivation following ART withdrawal until after viral amplification

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Abstract

To define the contribution of CD8+ T cell responses to control of SIV reactivation during and following antiretroviral therapy (ART), we determined the effect of long-term CD8+ T cell depletion using a rhesusized anti-CD8β monoclonal antibody on barcoded SIVmac239 dynamics on stable ART and after ART cessation in rhesus macaques (RMs). Among the RMs with full CD8+ T cell depletion in both blood and tissue, there were no significant differences in the frequency of viral blips in plasma, the number of SIV RNA+ cells and the average number of RNA copies/infected cell in tissue, and levels of cell-associated SIV RNA and DNA in blood and tissue relative to control-treated RMs during ART. Upon ART cessation, both CD8+ T cell–depleted and control RMs rebounded in fewer than 12 days, with no difference in the time to viral rebound or in either the number or growth rate of rebounding SIVmac239M barcode clonotypes. However, effectively CD8+ T cell–depleted RMs showed a stable, approximately 2-log increase in post-ART plasma viremia relative to controls. These results indicate that while potent antiviral CD8+ T cell responses can develop during ART-suppressed SIV infection, these responses effectively intercept post-ART SIV rebound only after systemic viral replication, too late to limit reactivation frequency or the early spread of reactivating SIV reservoirs.

Authors

Afam A. Okoye, Derick D. Duell, Yoshinori Fukazawa, Benjamin Varco-Merth, Alejandra Marenco, Hannah Behrens, Morgan Chaunzwa, Andrea N. Selseth, Roxanne M. Gilbride, Jason Shao, Paul T. Edlefsen, Romas Geleziunas, Mykola Pinkevych, Miles P. Davenport, Kathleen Busman-Sahay, Michael Nekorchuk, Haesun Park, Jeremy Smedley, Michael K. Axthelm, Jacob D. Estes, Scott G. Hansen, Brandon F. Keele, Jeffery D. Lifson, Louis J. Picker

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Figure 8

Effect of CD8+ T cell depletion on SIV infection dynamics after ART withdrawal.

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Effect of CD8+ T cell depletion on SIV infection dynamics after ART with...
(A) Kaplan-Meier analysis of SIV rebound kinetics in RMs with effective CD8+ T cell depletion (red; n = 7) and RMs with incomplete CD8+ T cell depletion (green; n = 3) versus IgG isotype controls (blue; n = 10). (B and C) Quantification of overall viral growth rates and SIVmac239M clonal reactivation rates in plasma by high-throughput sequencing after ART cessation. (D) Individual pvl profiles of RMs in each treatment group. Left panel shows anti-CD8β–treated RMs with effective CD8+ T cell depletion versus RMs with incomplete CD8+ T cell depletion (green), while the middle panel shows IgG isotype controls (blue). Right panel shows mean (+SEM) pvl profiles of RMs stratified by treatment group (limit of detection, 15 RNA copies/mL). Wilcoxon’s rank-sum test was used to determine significance of differences in the AUC of pvl between 14 and 20 weeks after mAb treatment (unadjusted P values shown). (E) Quantification of cell-associated SIV RNA in PBMCs, LNs, and BM (copies per 1 × 106 cell equivalents) at 8 and 16 days after ART cessation. Plots show jittered points with a box from first to third quartiles (IQR) and a line as the median, with whiskers extending to the farthest data point within 1.5 × IQR above and below the box, respectively. In B, C, and E, Wilcoxon’s rank-sum test was used to determine the significance of differences between treatment groups, first excluding RMs with incomplete CD8+ Tm depletion, and then including all treated RMs versus IgG controls (unadjusted P values shown). Closed symbols indicate Mamu-A*01+ RMs and open symbols indicate Mamu-B*08+ RMs.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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