Purpose of review: Measurements of HIV burden have relied upon quantification of viral nucleic acids by real-time PCR (qPCR). To develop and test strategies for eradication, new methods are needed to better characterize residual cellular reservoirs in patients on suppressive antiretroviral therapy (ART). This review summarizes recent advances that may lead to clinically useful tests with improved sensitivity, reproducibility and throughput.
Recent findings: HIV DNA remains the most sensitive measure of residual infection, but its low levels are difficult to differentiate from assay noise by qPCR. Digital PCR has begun to improve the precision of existing real-time assays, but there remains a need to distinguish replication-competent proviruses. Rapid technological progress in single-cell analysis is beginning to offer new approaches, notably CyTOF and microengraving, which could provide vastly more information about the composition of the latent reservoir.
Summary: To investigate and assess therapies directed towards eradication, improved assays that simultaneously offer high sensitivity, precision and information content will be needed.
aUniversity of California San Diego, La Jolla
bVeterans Affairs San Diego Healthcare System, San Diego, California, USA
Correspondence to Douglas Richman, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA 92093-0679, USA. Tel: +1 858 552 8585 x2620; fax: +1 858 552 7445; e-mail: firstname.lastname@example.org