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ResearchIn-Press PreviewAIDS/HIVImmunology Open Access | 10.1172/JCI207260

HIV reservoir cells do not show general resistance to effector molecules secreted by cytolytic T lymphocytes

Niklas Bachmann,1 Bailey Kim,2 Francesco R. Simonetti,1 Colin M. Kovacs,3 Rebecca Hoh,4 Steven G. Deeks,4 Janet D. Siliciano,1 and Robert F. Siliciano1

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Bachmann, N. in: PubMed | Google Scholar

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Kim, B. in: PubMed | Google Scholar

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Simonetti, F. in: PubMed | Google Scholar |

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Kovacs, C. in: PubMed | Google Scholar

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Hoh, R. in: PubMed | Google Scholar |

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Deeks, S. in: PubMed | Google Scholar |

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Siliciano, J. in: PubMed | Google Scholar

1Johns Hopkins University School of Medicine, Baltimore, United States of America

2Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, United States of America

3Maple Leaf Medical Clinic, Toronto, Canada

4UCSF, San Francisco, United States of America

Find articles by Siliciano, R. in: PubMed | Google Scholar |

Published October 29, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI207260.
Copyright © 2026, Bachmann et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published October 29, 2026 - Version history
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Abstract

To eliminate the persistent reservoir of cells harboring intact HIV-1 proviruses in people living with HIV-1 (PLWH), cure strategies like the Shock-and-Kill approach rely on effector functions of cytolytic T lymphocytes (CTL). CTL are involved in the initial control of HIV-1 viremia and target productively infected cells throughout the course of infection. However, selective killing of susceptible cells could generate a reservoir dominated by cells with dysregulated cell death pathways or other features conferring resistance to killing. Here, we use CTL-engaging single-chain diabodies to assess the rate of lysis of uninfected and HIV-1-infected primary CD4+ T cells under identical CTL pressure in the settings of both latent and active infection. Our findings indicate that with this mode of CTL triggering, infected and uninfected CD4+ T cells from PLWH on ART are generally lysed at identical rates, and that an apparent survival advantage for actively infected CD4+ T cells primarily reflects the reduced surface antigen availability through previously described Nef-dependent downregulation of MHC class I molecules. No survival advantage is observed when the CTL response is directed through diabodies to the stably expressed non-classical MHC class I molecule HLA-E, indicating equal susceptibility to cell death.

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

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