Mucosal HIV-1 Transmission in Humanized Mice
Denton, Paul Wesley
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HIV-1 infects ~6,800 people each and every day, transmitting predominantly through unprotected sexual contact. On a global scale, vaginal transmission now accounts for more than half of newly acquired HIV-1 infections. In developed countries intrarectal infection represents a major form of HIV-1 transmission. The social and economic toll of this disease has created an urgency to develop and implement novel approaches capable of preventing HIV-1 transmission. Yet this process has been hindered by the lack of adequate small animal models for pre-clinical efficacy and safety testing. Given the importance of mucosal HIV-1 transmission, the susceptibility of humanized mice to intrarectal and intravaginal HIV-1 infection was investigated. Human lymphocytes, including CD4+ T cells, generated in situ from hematopoietic stem cells reconstitute the gastrointestinal tract and the female reproductive tract of Bone marrow Liver Thymus (BLT) mice. The presence of human CD4+ T cells in these mucosal tissues renders BLT mice susceptible to both intrarectal and intravaginal HIV-1 transmission. Mucosally transmitted HIV-1 disseminates systemically in BLT mice. Effects of disseminated HIV-1 infection include a systemic loss of CD4+ T cells, particularly in gut associated lymphoid tissue, which closely mimics what happens in HIV-1 patients. The utility of humanized mice to study mucosal HIV-1 transmission is particularly highlighted by the demonstration herein that pre-exposure prophylaxis with antiretroviral drugs can prevent intravaginal HIV-1 transmission. This experimental finding has important implications for the clinical implementation of antiretroviral-based pre-exposure prophylactic measures to prevent the spread of AIDS. The goal of this dissertation project was to determine the suitability of the BLT mouse to serve as an animal model of HIV-1 transmission and as a model for assessing interventions aimed at preventing HIV-1 transmission. My conclusions are that BLT mice are susceptible to both intrarectal and intravaginal HIV-1 transmission and that pre-exposure prophylaxis with FDA approved antiretroviral drugs does prevent vaginal transmission in BLT mice. Thus, the BLT mouse system is an excellent candidate for pre-clinical evaluation of both microbicides and pre-exposure prophylactic regimens to prevent mucosal HIV-1 transmission.