Challenges and strategies for the eradication of the HIV reservoir

JT Kimata, AP Rice, J Wang - Current opinion in immunology, 2016 - Elsevier
Current opinion in immunology, 2016Elsevier
Highlights•Memory CD4+ T cells with latently integrated proviruses are a major barrier to
curing HIV infection.•Proviral integration within genes involved in cancer may contribute to
clonal proliferation of latently infected CD4+ T cells.•Challenges to clearing viral reservoirs
within B cell follicles of lymph nodes.•Immunotherapy shows promise for clearing HIV
infection.•Combination approaches may be necessary to cure HIV infection.Despite the
success of highly active antiretroviral therapy (HAART) for inhibiting HIV replication and …
Highlights
  • Memory CD4+ T cells with latently integrated proviruses are a major barrier to curing HIV infection.
  • Proviral integration within genes involved in cancer may contribute to clonal proliferation of latently infected CD4+ T cells.
  • Challenges to clearing viral reservoirs within B cell follicles of lymph nodes.
  • Immunotherapy shows promise for clearing HIV infection.
  • Combination approaches may be necessary to cure HIV infection.
Despite the success of highly active antiretroviral therapy (HAART) for inhibiting HIV replication and improving clinical outcomes, it fails to cure infection due to the existence of a stable latent proviral reservoir in memory CD4+ T cells. Because of the longevity of these cells harboring transcriptionally silent proviruses, devising strategies to induce viral gene expression so the host immune response can mediate clearance of the infected cells or the cells can undergo virus-induced cell death, has been of considerable recent interest. Here, we review current knowledge of latency, and the challenges to virus induction and eradication. Novel strategies to reactivate HIV reservoirs more effectively, in combination with immunotherapy, could lead to better clearance of the latent HIV reservoir.
Elsevier