Renewed interest has emerged to address the latent reservoir of HIV to achieve a cure.
The integrated proviral genome is a fundamental component of the retroviral replication cycle. The establishment of latently infected CD4+ lymphocytes, and perhaps other as yet poorly characterized cells, represents a reservoir of HIV infection that is not appreciably affected by effective antiretroviral chemotherapy. Effective management of HIV infection, thus, will require lifelong treatment unless an approach to purging this reservoir is identified. Although substantial insights about the latent reservoir have been made, our understanding about the details of the reservoirs, the mechanisms of latency and potential targets to eliminate latently infected cells is too primitive to achieve a cure without a great deal of basic research to elucidate some of these areas.
A resurgence of interest in latent infection and its treatment promises progress in addressing the challenge of a cure, although, realistically, this will require a prolonged period of investigation in many areas.
VA San Diego Healthcare System, Departments of Pathology and Medicine, Center for AIDS Research, University of California, San Diego, California, USA
Correspondence to Douglas D. Richman, MD, Stein Clinical Sciences Building, 9500 Gilman Drive, La Jolla, CA 92093-0679, USA Tel: +1 858 552 7439; fax: +1 858 552 7445; e-mail: email@example.com
This work was supported by the Department of Veterans Affairs and grants AI69432 (the UCSD Center for AIDS Research), AI047745, and AI080193 from the National Institutes of Health.