Xenotropic murine leukemia-related virus (XMRV) was identified in association with human prostate cancer and chronic fatigue syndrome. To examine the infection potential, kinetics, and tissue distribution of XMRV in an animal model, we inoculated five macaques with XMRV intravenously. XMRV established a persistent, chronic disseminated infection, with low transient viremia and provirus in blood lymphocytes during acute infection. Although undetectable in blood after about a month, XMRV viremia was reactivated at 9 months, confirming the chronicity of the infection. Furthermore, XMRV Gag was detected in tissues throughout, with wide dissemination throughout the period of monitoring. Surprisingly, XMRV infection showed organ-specific cell tropism, infecting CD4 T cells in lymphoid organs including the gastrointestinal lamina propria, alveolar macrophages in lung, and epithelial/interstitial cells in other organs, including the reproductive tract. Of note, in spite of the intravenous inoculation, extensive XMRV replication was noted in prostate during acute but not chronic infection even though infected cells were still detectable by fluorescence in situ hybridization (FISH) in prostate at 5 and 9 months postinfection. Marked lymphocyte activation occurred immediately postinfection, but antigen-specific cellular responses were undetectable. Antibody responses were elicited and boosted upon reexposure, but titers decreased rapidly, suggesting low antigen stimulation over time. Our findings establish a nonhuman primate model to study XMRV replication/dissemination, transmission, pathogenesis, immune responses, and potential future therapies.Xenotropic murine leukemia-related virus (XMRV) is a novel gammaretrovirus, initially identified in human prostate cancer using a Virochip DNA microarray (43) in men with a low-activity variant of RNASEL, an enzyme involved in innate immunity via type I interferons (14). Although related to murine leukemia virus (MLV) and probably acquired by zoonotic infection, human tissue-derived XMRV clearly segregates from other gammaretroviruses, genotypically arguing against the hypothesis that such human infection is acquired via repeated zoonotic transmission (43). The association of XMRV with prostate cancer has since been confirmed by other laboratories, albeit with a potentially different cellular tropism (34). In addition, association with RNASEL deficiency has been variable (1, 7, 15, 34), suggesting that low levels of RNASEL may not be a requirement for productive infection or viral propagation in humans. Nevertheless, the association of RNASEL mutations and prostate cancer has been reinforced by the recent discovery that a prostate cell line, 22Rv1, was derived from a patient with a low-activity RNASEL genotype (15). RNASEL dysfunction has also been associated with another disease, chronic fatigue syndrome (CFS) (8,20,21,38,42), which prompted an investigation into a potential association of XMRV with CFS. In a geographically restricted cohort, up to 67% of CFS patients were found ...