Human immunodeficiency virus type 1 (HIV-1) replication is continuous and occurs vigorously in infected individuals (4, 17, 28, 42). Primary acute HIV-1 infection is characterized by extremely high levels of plasma viremia, with values in excess of 106 copies of viral RNA/ml of blood (7). Resolution of the acute phase of HIV-1 infection correlates well with the appearance of robust cytotoxic T-cell responses to the virus (18, 21, 24, 34) and is followed by a variable period of clinical latency. The viral titer rapidly decreases to a new steady state that varies among individuals (the plasma HIV-1 RNA levels are typically in the range of 102 to 105 copies/ml) and is ultimately predictive of the subsequent rate of disease progression (23). Although the asymptomatic phase of infection is characterized by an absence of clinical symptoms, there is persistent replication of virus throughout the lymphoid system, especially in the germinal centers of peripheral lymph nodes (6, 25, 29). Remarkably, during this phase, the level of HIV-1 RNA in the plasma is reasonably stable in a given individual and reflects a quasi-steady state in which virus production equals virus clearance (4, 7). Most of the plasma virus detected comes from recently infected CD4+ lymphocytes. Some studies have estimated that as many as one-third of peripheral and lymphoid CD4+ lymphocytes are HIV DNA positive, with a small proportion of them (0.1 to 1%) expressing viral RNA at any given time (3, 6, 25). These virus-infected T cells in vivo are turned over rapidly and have a short half-life (t1/2 ≈ 2 days) (1, 17, 28, 31, 32, 42). The rapid turnover of these infected CD4+ lymphoblasts is probably due to both virus-induced cytopathic effects and the host cytolytic effector mechanisms. Current in vitro assays for viral replication do not accurately represent this situation because they do not take into account the short half-life of infected cells in vivo. Therefore, in vitro culture systems used to analyze HIV-1 gene function do not have the same selective constraints as those present in vivo. In this study, we have designed an in vitro assay system that mimics the short life span of infected T cells and the constant replenishment of uninfected target cells (the rapid-turnover assay). HIV-1-infected Jurkat T cells were killed every 3 days by the addition of a cytocidal agent and then cocultured with fresh uninfected Jurkat T cells. Sustained high level of viral replication was not achieved under rapid-turnover assay conditions following infection with HIVLai. However, continued propagation of the virus-infected cells led to the emergence of a new viral variant that could replicate under the selective conditions of rapid cell turnover. Spread of virus under the rapid-turnover conditions was correlated with a change in phenotype of the virus (increased numbers and sizes of syncytia). The virus was molecularly cloned, and the region responsible for the replication in the rapid-turnover assay was mapped by analysis of viral chimeras. The region of the virus that conferred this new phenotype mapped to a frameshift mutation in the vpu open reading frame (ORF) that was shown to be sufficient for survival and growth in the rapid-turnover assay. Moreover, the vpu mutation alone was responsible for converting the virus to one that spreads predominately by cell-to-cell fusion. Since viral replication in a system with rapid cell turnover kinetics depends on cell-to-cell transfer of virus, our data support the hypothesis that cell-to-cell spread of HIV is the predominant route of viral spread in vivo.