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A population at low census might go extinct or instead transition into exponential growth to become firmly established. Whether this pivotal event occurs for a within-host pathogen can be the difference between health and illness. Here, we define the principles governing whether HIV-1 spread among cells fails or becomes established by coupling stochastic modeling with laboratory experiments. Following ex vivo activation of latently infected CD4 T cells without de novo infection, stochastic cell division and death contributes to high variability in the magnitude of initial virus release. Transition to exponential HIV-1 spread often fails due to release of an insufficient amount of replication-competent virus. Establishment of exponential growth occurs when virus produced from multiple infected cells exceeds a critical population size. We quantitatively define the crucial transition to exponential viral spread. Thwarting this process would prevent HIV transmission or rebound from the latent reservoir.
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•Transition from latency to exponential HIV growth is covert, rare, and stochastic•After latency disruption, the initial HIV release amount is highly variable•If the initial virus release exceeds a critical threshold, exponential spread ensues•Coupling experimental and computational approaches can define the origin of HIV rebound
Transition to exponential growth is a canonical mode of population establishment. For HIV spread among cells following latency disruption, Hataye et al. discover that this crucial transition occurs if the initial virus release exceeds a critical growth threshold, which can trigger HIV rebound.