HIV-1 infection causes depletion of monocytic cells through a non-canonical cell death pathway

Programmed cell death is a regulatory mechanism to eliminate infected or damaged cells. Several programmed cell death pathways exist, including apoptosis, necroptosis and pyroptosis, which can be distinguished by the cellular molecules involved. Here we show that infection of monocytic cells with HIV-1 causes cell death, which is dose- and cell type dependent and occurs independently of nucleic acid sensing or interferon (IFN) signaling. Death is observed in the case of near full-length viruses that produce viral proteins upon infection, but not in case of a minimal lentiviral vector that does not express viral gene products, demonstrating the necessity of viral gene products or a near-full length RNA genome to trigger death. Inhibition of reverse transcription or integration rescues cells, indicating that a step after integration is responsible. Using mutant viruses, we further narrow down the step in the retroviral replication cycle that triggers death. Inhibition of diverse cell death pathways individually cannot rescue cells from death following infection, consistent with PANoptosis, a cellular death process that cannot be accounted for by any single programmed cell death pathway alone. Our results elucidate the viral and cellular determinants of cell death caused by HIV-1 infection and outline cellular responses that result in the depletion of specific cell populations.