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Updated: May 23, 2026

Interview: HIV-1 Proviral DNA Excision Using an Evolved Recombinase
Published on: June 16, 2008
HIV RNA suppression and immune restoration: can we do better?
Marilia Rita Pinzone1, Michelino Di Rosa, Bruno Cacopardo
1Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, University of Catania, Catania 95125, Italy. marilia.pinzone@virgilio.it
Abstract:
HAART has significantly changed the natural history of HIV infection: patients receiving antiretrovirals are usually able to control viremia, even though not all virological responders adequately recover their CD4+ count. The reasons for poor immune restoration are only partially known and they include genetic, demographic and immunologic factors. A crucial element affecting immune recovery is immune activation, related to residual viremia; indeed, a suboptimal virological control (i.e., low levels of plasma HIV RNA) has been related with higher levels of chronic inflammation and all-cause mortality. The sources of residual viremia are not yet completely known, even though the most important one is represented by latently infected cells. Several methods, including 2-LTR HIV DNA and unspliced HIV RNA measurement, have been developed to estimate residual viremia and predict the outcome of antiretroviral therapy. Considering that poor immunologic responders are exposed to a higher risk of both AIDS-related and non-AIDS-related diseases, there is a need of new therapeutic strategies, including immunomodulators and drugs targeting the latent viral reservoirs, in order to face residual viremia but also to "drive" the host immunologic responses.
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