The results presented clearly show that the generation of a pathogenic R5-SHIV was not a trivial undertaking. Animal-to-animal passaging eventually gave rise to SHIV
AD8#2, possessing greatly augmented infectivity for rhesus PBMC compared to the starting SHIV
AD8 construct. Although it was not appreciated at the time, SHIV
AD8#2 had also acquired improved
in vivo properties, as evidenced by its and its immediate derivatives' capacity to cause fatal immunodeficiency in 8 of 13 inoculated rhesus monkeys (Fig. and Table ). The most consistent and distinguishing property of the passaged SHIV
AD8 family of viruses during infections of rhesus macaques was the slow and unremitting loss of both memory and naïve CD4
+ T cells (Fig. ), a pattern of depletion observed in all 10 NPs. Surprisingly, and in contrast to both SIVmac and SIVsmE lineages, the pace of CD4
+ T lymphocyte decline was not correlated with plasma virus loads. Although the geometric mean plasma viral-RNA level at week 50 in the SHIV
AD8-infected monkey cohort was 1.7 × 10
3 RNA copies/ml, the set-point virus loads varied widely in the 10 infected animals (1.6 × 10
2 to 1.5 × 10
5 RNA copies/ml). This variability was also observed in pairs of animals inoculated with identical SHIV
AD8#2 derivatives (
viz. CK15 and CJ58, and DB99 and DA1Z). An extreme example of the nonlinkage between viral-RNA levels and CD4
+ T cell loss with SHIV
AD8 occurred with animal CK5G, which had 43 and 42 circulating naïve and memory CD4
+ T cells/μl, respectively, at week 86 p.i. and a plasma viral load of only 5.4 × 10
2 RNA copies/ml. During the chronic phase of SHIV
AD8 infections, the loss of naïve CD4
+ T cells was more rapid and more marked than the depletion of the memory subset, as was previously observed in SIVsmE543-infected animals (
35) (Fig. ). By week 80, for example, NPs had sustained an 87 to 93% loss of naïve CD4
+ T cells from their preinoculation levels, whereas the depletion of memory cells was significant, but not as pronounced. The dissociation of plasma virus loads and CD4
+ T cell loss is reminiscent of the previously reported infection of pig-tailed macaques with SIVl'hoest and SIVsun (
4). In that study, 8 of 12 infected animals developed immunodeficiency over a 5-year period while maintaining set-point viremia between 10
2 and 10
3 RNA copies/ml.
We do not presently understand why naïve CD4
+ T lymphocytes are lost in SHIV
AD8 NPs. Based on coreceptor expression, this T cell subset expresses CXCR4, not CCR5, on its surface and should therefore be refractory to infection by R5-tropic SHIVs and virus-induced cell killing. An assessment of the coreceptor utilization status of late-stage viruses recovered from SHIV
AD8 NPs, in fact, revealed that a coreceptor switch had not occurred in these animals (see Fig. S2 in the supplemental material). Although a dissociation between viral-RNA levels and memory/naïve CD4
+ T cell loss was observed, the NPs did experience increased memory CD4
+ T lymphocyte turnover (see Fig. S1 in the supplemental material), even in animals with very low plasma virus loads. Activation-induced proliferation and killing of memory CD4
+ T cells during the lengthy chronic SHIV
AD8 infection might therefore be responsible for driving the differentiation of naïve CD4
+ lymphocytes into memory cells and impose an unsustainable drain on this CD4
+ T cell subset. It is also possible that SHIV
AD8 infection of rhesus macaques negatively affects naïve CD4
+ T lymphocyte homeostasis in the thymus, thereby impeding the differentiation or emigration of this T cell subset. It has also recently been reported that the loss of naive CD4
+ T cells during SIVsmE543 infections was associated with the presence of autoreactive antibodies to CD4
+ T lymphocytes, platelets, double-stranded DNA, and phospholipid (
27). Increased numbers of circulating IgG-coated CD4
+ T cells were observed in that study, and the levels of autoreactive antibodies were correlated with the extent of naïve CD4
+ T cell depletion.
Approximately 20% of rhesus monkeys infected with SIVmac/SIVsm lineage viruses become RPs, experiencing persistently high virus set points, rapid and complete losses of memory CD4
+ T cells, undetectable or transient antiviral antibody responses, and early onset (3 to 6 months p.i.) of symptomatic disease (
6). Despite losing virtually all of their memory CD4
+ T lymphocytes, SIV RPs, at the time of death, usually maintain preinoculation levels of naïve CD4
+ T cells (
35). This was not the case for SHIV
AD8 RPs. Although all three experienced early and massive depletions of memory CD4
+ T cells, two of the infected macaques had lost virtually all of their naïve CD4
+ T cells at the time of euthanasia. In one of these animals (DB99), the virus recovered at the time of euthanasia, as well as a virus pseudotyped with an Env possessing the RIG insertion in the V3 loop, had acquired the capacity to infect cells expressing CXCR4 (Fig. ). Interestingly, coreceptor switching has been previously reported to occur during RP infections of macaques inoculated with a different R5-tropic SHIV, SHIV
SF162P3 (
18,
19,
47). In one of the SHIV
SF162P3 coreceptor-switching events, the insertion of two positively charged amino acids (HR) immediately upstream of the V3 loop GPGR crown (Fig. ) was shown to confer X4 tropism (
18). In the case of SHIV
AD8-DB99, a 3-aa (RIG) insertion, also located in the N-terminal V3 stem and which increased the net charge of the V3 loop from +3 to +5, was responsible for the acquisition of CXCR4 usage. The insertion of HIG at the same location of the SHIV
AD8-A4E008 V3 region did not affect the net charge and did not confer tropism for CXCR4-expressing cells.
Independent and unrecognized cross-species transmissions and spread of SIVsm at different U.S. primate facilities during the 1970s contributed to the emergence of SIVmac and SIVsmE660 lineages with distinctive replicative and pathogenic phenotypes. The serial passaging of SHIVAD8 in rhesus monkeys described here also resulted in an AIDS-inducing primate lentivirus with its own characteristic properties. First, in contrast to commonly used pathogenic SIVs, SHIVAD8#2 and its immediate derivatives generated sustained but, as previously noted, highly variable set-point virus loads in NPs. Similarly variable viral loads were also observed in eight rhesus monkeys inoculated with four independent SHIVAD8 stocks prepared from macaques CK15, CE8J, CL98, and CJ58 at the time of their euthanasia (data not shown). Profound depletions of both memory and naïve CD4+ T cells, which accompany relatively low virus set points (geometric mean level, 1.7 × 103 RNA copies/ml) in NPs, is a second property that distinguishes the R5-tropic SHIVAD8 from pathogenic SIVs. Finally, unlike SIVs, SHIVAD8 RPs experience an initial loss of memory CD4+ T lymphocytes and a later rapid deletion of naïve CD4+ T cells prior to death, which in one animal occurred following a CCR5-to-CXCR4 coreceptor switch. Based on the results shown in Fig. and Table , we plan to use and distribute SHIVAD8#2LN, SHIVAD8#2PBMC, or the SHIVs recovered from NPs at the time of euthanasia (SHIVAD8-CL98, SHIVAD8-CK15, or SHIVAD8-CE8J) as challenge viruses in vaccine experiments. Animals inoculated with cell-free preparations of the last group of viruses have experienced variable but sustained plasma viremia associated with a gradual but significant CD4+ T cell loss during 30 weeks of infection. Some of these macaques have developed a rapid-progressor clinical course.