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Share your thoughts on this presentation with #IAS2019 Highly sensitive, limiting dilution-multiplex seminested quantitative PCR-based assay reveals a large active HIV-1 reservoir in infected ART-suppressed individuals and elite suppressors Alexander Pasternak Laboratory of Experimental Virology, Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, The Netherlands Share your thoughts on this presentation with #IAS2019

Optional: cell stimulation PBMCs from HIV-infected individual Limiting dilution in 0.5 million uninfected donor PBMC/well RNA isolation by the Boom method DNase treatment One-step RT + 1st PCR (multiplex US + MS RNA) PBMC per dilution 2,000,000 500,000 125,000 31,250 7,813 1,953 488 122 US RNA+ cells MS RNA+ cells qPCR US RNA (gag) qPCR MS RNA (tat/rev/nef) Frequencies of cells with US or MS RNA are determined using the maximum likelihood method Detection limit = 1 HIV RNA+ cell in 7.6 million cells (based on typical nr. of replicates)

All HIV-1 forms detectable in all individuals ** * ** 3 viremic therapy-naïve individuals, 5 aviremic ART-treated individuals, 2 elite suppressors No ex vivo stimulation All HIV-1 forms detectable in all individuals

in integrated DNA+ cells in integrated DNA+ cells % US RNA+ cells in integrated DNA+ cells % MS RNA+ cells in US RNA+ cells % MS RNA+ cells in integrated DNA+ cells

Kevin Groen Maria Feuchert Yara L. Verschoor Marilia R. Pinzone Laura K. DeMaster Una O’Doherty Ben Berkhout a.o.pasternak@amsterdamumc.nl