Antiviral Monocytes Increase Prior to Detectable HIV-1 Rebound Viremia.

The persistence of human immunodeficiency virus 1 (HIV-1) proviruses in latently infected cells allows viremia to resume upon treatment cessation. To characterize the resulting immune response, we compared plasma proteomics and single-cell transcriptomics of peripheral blood mononuclear cells before, during, and after detectable plasma viremia. We observed unique transcriptional signatures prior to viral rebound, including a significant increase in CD16++ monocytes with increased antiviral gene expression. Inflammatory proteins were identified in plasma after detectable rebound. Identifying early signals of imminent viral rebound after treatment cessation will aid in the development of strategies to prolong time to viral rebound and cure HIV-1.