TNF-related apoptosis-inducing ligand (TRAIL), a member of the TNF superfamily, was suggested to contribute to HIV-1 pathogenesis by inducing CD4 ؉ T cell death characteristic of AIDS. We previously reported HIV-1-mediated, TRAIL-induced apoptosis in primary CD4 ؉ T cells in vitro and observed elevated levels of plasma TRAIL in HIV-1-infected patients. The present study elucidates the unresolved mechanism by which HIV-1 induces TRAIL expression on primary CD4 ؉ T cells. We demonstrate that the expression of TRAIL by primary CD4 ؉ T cells is regulated by IFN-␣ that is produced by HIV-1-stimulated plasmacytoid dendritic cells (pDCs). We also found that IFN-induced TRAIL is mediated by signal transducers and activators of transcription 1 and 2. We show that IFN-␣ production by HIV-1-activated pDCs is blocked by an early viral entry inhibitor of CD4-gp120 binding, but not by inhibitors of viral coreceptor binding. Our in vitro data are supported by the demonstration that anti-IFN-␣ and - Abs inhibit apoptosis and TRAIL expression in CD4 ؉ T cells from HIV-1-infected patients. Our findings suggest a potential unique role of pDCs in the immunopathogenesis of HIV-1 infection by inducing the death molecule TRAIL.T NF-related apoptosis-inducing ligand (TRAIL), a TNF superfamily member (1), has two death receptors (DRs) that induce apoptosis (2) (DR4 and DR5) and three other receptors that lack the death domain and engage ligand without initiating apoptosis (3). TRAIL protein is expressed on the cell membrane (mTRAIL) or is secreted (soluble TRAIL) (1), and both the soluble and membrane-bound forms induce apoptosis of cells expressing functional DRs (4). TRAIL may contribute to HIV-1 immunopathogenesis because CD4 ϩ and CD8 ϩ T cells from HIV-1-infected patients are more susceptible to TRAILinduced apoptosis in vitro than T cells from healthy donors (5-7). TRAIL induced the selective apoptosis of uninfected CD4 ϩ T cells in HIV-1-infected hu-PBL-NOD-SCID mice (8). TRAIL, produced by monocytes exposed to the HIV-1 Tat protein, induced apoptosis of uninfected CD4 ϩ T cells (9). We recently reported that plasma TRAIL levels in HIV-1-infected patients directly correlate with viral load (10). We also reported that CD4 ϩ T cells exposed to HIV-1 underwent apoptosis by a TRAIL-DR5-dependent mechanism, which was inhibited by anti-type I IFN Abs (11). These latter results suggest that type I IFN plays a fundamental role in HIV-1-induced TRAIL expression by CD4 ϩ T cells.Type I IFN (IFN-␣͞) has antiviral activity, including activity against HIV-1 (12). IFN-␣͞ are produced mainly by plasmacytoid dendritic cells (pDCs) (13). pDCs are located in blood and lymphoid tissue (13-15) and participate in innate immune responses against viruses by producing large amounts of 17). Interestingly, pDCs secrete type I IFN when stimulated by infectious HIV-1 or chemically inactivated HIV-1 virions (18). The majority of plasma HIV-1 is not infectious (19,20), raising the possibility that such virions contribute to HIV-1 pathogenesis and CD4 ϩ T c...