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Perspective on potential impact of HIV CNS latency on eradication

Chan, Phillipa; Ananworanich, Jintanata , b , c , d

doi: 10.1097/QAD.0000000000002264
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Given the challenges of life-long adherence to suppressive HIV antiretroviral therapy (ART) and possibilities of comorbidities such as HIV association neurocognitive disorder, HIV remission and eradication are desirable goals for people living with HIV. In some individuals there is evidence that HIV persists and replicates in the CNS, impacting the success of HIV remission interventions. This article addresses the role of HIV CNS latency on HIV eradication, examines the effects of early ART, latency modifying agents, antibody-based and T-cell enhancing therapies on the CNS as well as ART interruption in remission studies. We propose the integration of CNS monitoring into such studies in order to clarify the short- and long-term neurological safety of experimental agents and treatment interruption, and to better characterize their effects on HIV CNS persistence.

aSEARCH Thailand, Thai Red Cross AIDS Research Centre, Bangkok, Thailand

bU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA

cHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA

dDepartment of Global Health, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Correspondence to Jintanat Ananworanich, Bethesda, UNITED STATES. E-mail: jananworanich@hivresearch.org

Received 19 May, 2018

Revised 11 April, 2019

Accepted 11 April, 2019

Copyright © 2019 Wolters Kluwer Health, Inc.