This article provides an overview of anticancer therapies in various stages of clinical development as potential interventions to target HIV persistence.
Epigenetic drugs developed for cancer have been investigated in vitro, ex vivo and in clinical trials as interventions aimed at reversing HIV latency and depleting the amount of virus that persists on antiretroviral therapy. Treatment with histone deacetylase inhibitors induced HIV expression in patients on antiretroviral therapy but did not reduce the frequency of infected cells. Other interventions that may accelerate the decay of latently infected cells, in the presence or absence of latency-reversing therapy, are now being explored. These include apoptosis-promoting agents, nonhistone deacetylase inhibitor compounds to reverse HIV latency and immunotherapy interventions to enhance antiviral immunity such as immune checkpoint inhibitors and Toll-like receptor agonists.
A curative strategy in HIV will likely need to both reduce the amount of virus that persists on antiretroviral therapy and improve anti-HIV immune surveillance. Although we continue to explore advances in the field of oncology including cancer immunotherapy, there are major differences in the risk–benefit assessment between HIV-infected individuals and patients with malignancies. Drug development specifically targeting HIV persistence will be the key to developing effective interventions with an appropriate safety profile.
aThe Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Victoria, Australia
bDepartment of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
cDepartment of Infectious Diseases, Alfred Hospital and Monash University, Victoria, Australia
Correspondence to Dr Thomas A. Rasmussen, MD, PhD, Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Boulevard, 8200 Aarhus N, Denmark. Tel: +45 31 70 29 64; email: email@example.com