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Modeling HIV infection, treatment, rebound, and intervention in human immune organoids

Sarah A. Sackey, Jacob E. Schrum, Uma M. Mangalanathan, Rachel S. Fish, Elsa Sola, Ahmad Selehi, Ruoxi Pi, Jerome A. Zack, Jocelyn T. Kim, Dara A. Lehman, Mark M. Davis, Catherine A. Blish
doi: https://doi.org/10.64898/2026.01.25.701611
Sarah A. Sackey
1Stanford Immunology Program, Stanford University School of Medicine, Stanford, CA, USA
2Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Jacob E. Schrum
2Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Uma M. Mangalanathan
2Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Rachel S. Fish
3Division of Human Biology, Fred Hutch Cancer Center, Seattle, WA, USA
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Elsa Sola
4Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA, USA
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Ahmad Selehi
5Donor Network West, San Ramon, California, USA
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Ruoxi Pi
2Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Jerome A. Zack
6Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, California, USA
7Department of Medicine, Division of Hematology and Oncology, University of California, Los Angeles, Los Angeles, California, USA
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Jocelyn T. Kim
8Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, California, 90095, USA
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Dara A. Lehman
3Division of Human Biology, Fred Hutch Cancer Center, Seattle, WA, USA
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Mark M. Davis
1Stanford Immunology Program, Stanford University School of Medicine, Stanford, CA, USA
4Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA, USA
9Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
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Catherine A. Blish
1Stanford Immunology Program, Stanford University School of Medicine, Stanford, CA, USA
2Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
10Chan Zuckerberg Biohub, San Francisco, CA, USA
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  • For correspondence: cblish{at}stanford.edu
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Abstract

Targeting the HIV-infected reservoir in lymphoid tissues (LT) will be critical to developing a cure for people living with HIV (PLWH). LT explants used to study HIV infection enable the evaluation of human-specific disease progression and treatment response; however, their short lifespan makes it challenging to assess long-term treatment interventions. We therefore established an immune organoid model of HIV infection using human tonsil or spleen cells, demonstrating productive HIV infection and viral integration into CD4+ T cells. Treatment with a protease inhibitor fully suppressed ongoing viral production, with virologic rebound occurring within days of treatment interruption. The transfer of healthy allogeneic NK cells to target the reservoir upon treatment interruption reduced the number of infected cells, intact viral genomes, and production of de novo infectious viral particles. Adoption of this immune organoid platform will accelerate the evaluation of cure-based strategies to eliminate the HIV reservoir in tissues for PLWH.

Competing Interest Statement

J.A.Z is a co-founder of CDR3 Therapeutics. C.A.B is a member of the Scientific Advisory Boards of ImmuneBridge and DeepCell, Inc. on topics unrelated to this project.

Funder Information Declared

NIH, R01 AI161803, R01 AI183381, T32AI007290, T32 AI007502
NCRR, 1S10OD032300-01
Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
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Posted January 27, 2026.
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Modeling HIV infection, treatment, rebound, and intervention in human immune organoids
Sarah A. Sackey, Jacob E. Schrum, Uma M. Mangalanathan, Rachel S. Fish, Elsa Sola, Ahmad Selehi, Ruoxi Pi, Jerome A. Zack, Jocelyn T. Kim, Dara A. Lehman, Mark M. Davis, Catherine A. Blish
bioRxiv 2026.01.25.701611; doi: https://doi.org/10.64898/2026.01.25.701611
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Modeling HIV infection, treatment, rebound, and intervention in human immune organoids
Sarah A. Sackey, Jacob E. Schrum, Uma M. Mangalanathan, Rachel S. Fish, Elsa Sola, Ahmad Selehi, Ruoxi Pi, Jerome A. Zack, Jocelyn T. Kim, Dara A. Lehman, Mark M. Davis, Catherine A. Blish
bioRxiv 2026.01.25.701611; doi: https://doi.org/10.64898/2026.01.25.701611

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