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HIV-1 reservoir dynamics in CD4+ T cells

Bruner, Katherine M.a,*; Cohn, Lillian B.b,*

Current Opinion in HIV and AIDS: March 2019 - Volume 14 - Issue 2 - p 108–114
doi: 10.1097/COH.0000000000000521
T-CELLS IN HIV INFECTION: Edited by Mathias Lichterfeld and Tony Kelleher
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Purpose of review To provide a summary of the recent data examining infected CD4+ T cell dynamics during ART and implications for cure strategies.

Recent findings HIV-1 cure is a worldwide unmet medical need. Although combination antiretroviral therapies effectively suppress HIV-1 replication in vivo, viral rebound occurs shortly after therapy cessation. The major barrier to HIV-1 cure is a pool of latently infected CD4+ T cells, called the latent reservoir, which is established early during infection, has a long half-life in vivo, and is not eliminated by treatment. It was thought that the stability of the reservoir came from long-lived latently infected CD4+ T cells, but more recent data suggests that the reservoir is dynamic, such that there is an equilibrium in which proliferation of HIV-1-infected cells is offset by an equivalent loss of cells harboring HIV-1 DNA.

Summary We review the evidence to support this dynamic model of persistence, mechanisms by which infected cells expand and are eliminated, and discuss the impact of a dynamic reservoir on the future of HIV-1 cure studies.

aDepartment of Molecular Biosciences, The University of Texas at Austin, Texas

bChan Zuckerberg Biohub, San Francisco, California, USA

Correspondence to Lillian B. Cohn, PhD, Chan Zuckerberg Biohub, 499 Illinois Street, San Francisco, CA 94158, USA. E-mail: lillian.cohn@czbiohub.org

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