Hiding in plain sight - platelets, the silent carriers of HIV-1

• Published in: Platelets (Edinburgh) 2021-11, Vol.32 (8), p.1038-1042
• Main Authors: Baumer, Yvonne, Weatherby, Tina M, Mitchell, Brooks I, SahBandar, Ivo N, Premeaux, Thomas A, Michelle L, D'Antoni, Gutierrez-Huerta, Cristhian A, Powell-Wiley, Tiffany M, Brown, Timothy R, Boisvert, William A, Shikuma, Cecilia M, Ndhlovu, Lishomwa C
• Format: Article
• Language: English
• Subjects: Blood Platelets - metabolism; HIV Infections - blood; hiv-1; HIV-1 - pathogenicity; hiv-1 persistence; hiv-1 reservoir; Humans; monocytes; platelets
• ISSN: 0953-7104; 1369-1635; 1369-1635
• DOI: 10.1080/09537104.2020.1849606

There are approximately 38 million people globally living with Human immunodeficiency virus 1 (HIV-1) and given the tremendous success of combination antiretroviral therapy (cART) this has dramatically reduced mortality and morbidity with prevention benefits. However, HIV-1 persists during cART within the human body and re-appears upon cART interruption. This HIV-1 reservoir remains a barrier to cure with cellular sites of viral persistence not fully understood. In this study we provide evidence corroborating a recently published article in STM demonstrating the role of platelets as a novel cellular disseminator of HIV-1 particles in the setting of viral suppression. Using classical transmission electron microscopy with and without immunogold labeling, we visualize HIV-1 in both platelets and monocytes in cART suppressed HIV donors. Our study suggests that due to the close proximity of platelets and monocytes an alternative life cycle of HIV-1 cycling within monocytes and platelets without the need of active replication under cART occurs. Our findings are supported by the lack of detectable HIV-1 particles in platelets derived from HIV uninfected donors or the 'Berlin' patient suggesting that platelets may serve as an underappreciated hidden bearer for HIV-1 and should be considered in HIV remission studies and trials.