Effective antiretroviral therapy (ART) blunts viremia, enabling HIV-1-infected individuals to control infection and live long, productive lives. However, HIV-1 infection remains incurable owing to the persistence of infected cells harboring integrated provirus within host cellular DNA. This latent infection is unaffected by ART and hidden from the immune system. In the renewed efforts to eradicate persistent infection, spurred in part by the remarkable case of Timothy Brown, initial studies have focused on the development of therapies to disrupt latency. These efforts unmasked residual viral genomes but highlighted the challenge of impacting the diverse viral reservoir in a clinically safe manner, and the need to enable the speedy clearance of latently infected cells. New efforts have begun to use both old and new strategies to enhance the HIV-1-specific immune response, and in a few cases efforts to bring the kick against latency together with the kill of persistently infected cells. Although very substantial challenges remain, the broad and inventive efforts launched to develop eradication therapy inspire hope.
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.