Eliminating the HIV reservoir

Area of Science:

• Virology
• Immunology
• Infectious Diseases

Background:

• Antiretroviral therapy (ART) effectively manages human immunodeficiency virus (HIV) but does not eliminate the viral reservoir.
• The persistent HIV reservoir comprises long-lived, therapy-inaccessible cells, hindering treatment cessation.
• Challenges with ART include compliance, drug resistance, toxicity, and cost.

Purpose of the Study:

• To review recent advances in understanding HIV reservoir biology and maintenance mechanisms.
• To discuss strategies for purging or controlling the residual HIV reservoir.
• To outline considerations for designing future HIV eradication trials.

Main Methods:

• Review of recent scientific literature on HIV persistence and reservoir dynamics.
• Analysis of current and emerging therapeutic strategies targeting the HIV reservoir.
• Discussion of clinical trial design principles for HIV eradication studies.

Main Results:

• Major advances have been made in understanding HIV reservoir nature and maintenance.
• Several novel molecules targeting the reservoir have been identified and some are in clinical trials.
• New strategies are needed to purge or control the reservoir for potential HIV cure.

Conclusions:

• Achieving a functional or sterilizing cure for HIV requires addressing the persistent viral reservoir.
• Ongoing research and clinical trials are crucial for developing effective HIV eradication strategies.
• Future HIV eradication trials must be carefully designed to assess novel therapeutic approaches.