Barriers to a cure for HIV: New ways to target and eradicate HIV-1 reservoirs

Christine Katlama, Steven G. Deeks, Brigitte Autran, Javier Martinez-Picado, Jan Van Lunzen, Christine Rouzioux, Michael Miller, Stefano Vella, Joern E. Schmitz, Jeffrey Ahlers, Douglas D. Richman, Rafick P. Sekaly

Research output: Contribution to journalReview articleResearchpeer-review

215 Citations (Scopus)

Abstract

Antiretroviral therapy for HIV infection needs lifelong access and strict adherence to regimens that are both expensive and associated with toxic effects. A curative intervention will be needed to fully stop the epidemic. The failure to eradicate HIV infection during long-term antiretroviral therapy shows the intrinsic stability of the viral genome in latently infected CD4T cells and other cells, and possibly a sustained low-level viral replication. Heterogeneity in latently infected cell populations and homoeostatic proliferation of infected cells might affect the dynamics of virus production and persistence. Despite potent antiretroviral therapy, chronic immune activation, inflammation, and immune dysfunction persist, and are likely to have important effects on the size and distribution of the viral reservoir. The inability of the immune system to recognise cells harbouring latent virus and to eliminate cells actively producing virus is the biggest challenge to finding a cure. We look at new approaches to unravelling the complex virus-host interactions that lead to persistent infection and latency, and discuss the rationale for combination of novel treatment strategies with available antiretroviral treatment options to cure HIV. Copyright © 2013 Elsevier B.V.
Original languageEnglish
Pages (from-to)2109-2117
JournalThe Lancet
Volume381
Issue number9883
DOIs
Publication statusPublished - 1 Jan 2013

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