We recently isolated from an infant an X4-syncytium-inducing (SI) human immunodeficiency virus type 1 (HIV-1) variant (92US143-T8) that was able to infect CD8؉ lymphocytes independently of CD4. Although it was CD4 independent, the 92US143-T8 isolate also maintained the ability to infect CD4 ؉ cells. In the present study, we investigated the role of CXCR4 in the infection of CD4؉ and CD8 ؉ cells by this primary isolate. The expression of CXCR4 was down modulated in CD8؉ lymphocytes after infection with the 93US143-T8 isolate.
Infection of CD8؉ lymphocytes by the 93US143-T8 isolate was prevented by treatment with AMD3100, a specific antagonist for CXCR4, indicating CXCR4-dependent infection. Interestingly, AMD3100 treatment had no inhibitory role in the infection of purified CD4؉ lymphocytes by the same isolate. Furthermore, AMD3100 treatment failed to prevent infection of known CD4 ؉ CXCR4 ؉ T-cell lines (MT-2 and CEM) by the 93US143-T8 isolate. In fact, virus replication in the CD4؉ cells was often enhanced in the presence of AMD3100. Viruses produced from the infected CD4؉ cells in the presence of AMD3100 maintained an unchanged envelope genotype and an SI phenotype. For the first time, these results provide evidence of CXCR4-dependent infection of CD8 ؉ lymphocytes by a primary HIV-1 isolate. This study also shows a different mode of infection for the CD4 ؉ and CD8 ؉ lymphocytes by the same HIV-1 variant. Finally, our findings suggest that a more careful evaluation is necessary before the random use of AMD3100 as a new entry inhibitor in patients harboring SI HIV-1 strains.Although a large number of chemokine receptors that can play critical roles as coreceptors for human immunodeficiency virus (HIV) entry have been identified, primary HIV type 1 (HIV-1) isolates generally use either CXCR4 (X4 strains) or CCR5 (R5 strains) as a coreceptor for infection of CD4 ϩ cells (13). X4 viruses generally appear late in HIV-1 disease, and their appearance is frequently associated with rapid progression to AIDS. However, many HIV-1 isolates that use CXCR4 are also capable of using CCR5 and thus are called dual tropic (R5X4) (6,16,26). X4 and R5X4 viruses are able to infect a larger proportion of the immune cells because, unlike CCR5, the CXCR4 molecules are abundantly expressed on most primary T cells, including the resting T lymphocytes (7). Furthermore, X4 and R5X4 isolates frequently form syncytia in CD4 ϩ cells in vitro, and it is believed that these viruses are primarily responsible for the profound loss of CD4 ϩ cells in the late stages of HIV-1 disease (17). AMD3100, a bicyclam compound, is a specific antagonist for CXCR4 that has emerged as a potent inhibitor of infection by X4 and R5X4 strains (11,15,21,22,28,38). Strong selection pressure against the more pathogenic X4 strains has prompted the suggestion that AMD3100 might be used even in asymptomatic HIV-1-infected patients to prevent the emergence of the more pathogenic X4 viruses (11, 15). We have recently isolated CD4-independent variants from the quasispecie...