Understanding how some HIV-infected cells resist the cytotoxicity of HIV replication is crucial to enabling HIV cure efforts. HIV killing of CD4 T cells that replicate HIV can involve HIV protease-mediated cleavage of procaspase 8 to generate a fragment (Casp8p41) that directly binds and activates the mitochondrial proapoptotic protein BAK. Here, we demonstrate that Casp8p41 also binds with nanomolar affinity to the antiapoptotic protein Bcl-2, which sequesters Casp8p41 and prevents apoptosis.
Intense activity is focused on identifying a clinical intervention that results in a long term, drug free remission of HIV-1 infection. Latently infected CD4 T cells harbor transcriptionally silent, replication-competent HIV. Because these cells persist long term and are unaffected by current therapies, the cells represent an HIV reservoir that remains undiminished by current approaches. Pilot clinical trials have tested whether reactivation of HIV-1 from latency will decrease the number of cells containing HIV DNA due to viral cytopathic effect or immune-mediated clearance. The latency reversal agents vorinostat, panobinostat, and romidepsin result in HIV reactivation, as measured by increases in cell-associated HIV RNA, but no change in cell-associated HIV DNA, indicating that the reactivating cells do not die (1-4). Multiple ongoing studies are testing augmentation of the anti-HIV immune response in combination with viral reactivation as a strategy for HIV eradication.In an effort to inform these attempts to eradicate the HIV reservoir, we and others have been examining the mechanistic basis for HIV-induced killing of CD4 T cells under different circumstances of activation and HIV replication. Although numerous pathways may contribute to the decline of uninfected CD4 T cells during uncontrolled HIV infection (5), fewer pathways have been implicated in the demise of cells directly infected by HIV. After HIV attachment, at least three distinct pathways can initiate the death of infected cells: (i) RIG-I-mediated sensing of HIV RNA (6, 7), (ii) IFI-16 sensing of unintegrated HIV DNA (8, 9), and (iii) DNA-PK-sensing of HIV integrase nicking of host DNA (10). Once integrated into host DNA, HIV can remain in a latent state