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Desentrañando las causas fundamentales de la persistencia del VIH-1
Weiwei Sun1,2, Mathias Lichterfeld1,2
1Ragon Institute of Mass General Brigham, MIT and Harvard, Cambridge.
Current opinion in HIV and AIDS
|February 17, 2026
Resumen
A pesar de la terapia antirretroviral (TAR) eficaz, el VIH-1 persiste debido a una compleja interacción de factores. Comprender estos mecanismos es clave para desarrollar estrategias que eliminen el reservorio persistente de VIH-1.
Área de la Ciencia:
- Virología
- Inmunología
- Biología Celular
Sus antecedentes:
- La terapia antirretroviral (TAR) suprime eficazmente las cargas virales del VIH-1 pero no elimina el reservorio viral de por vida.
- La infección persistente por VIH-1 representa un desafío significativo para lograr una cura completa.
Objetivo del estudio:
- Revisar los descubrimientos recientes sobre las causas de la persistencia del VIH-1 a pesar de la TAR.
- Ofrecer perspectivas para futuras intervenciones terapéuticas dirigidas al reservorio del VIH-1.
Principales métodos:
- Secuenciación de provirus
- Mapeo del sitio de integración cromosómica
- Seguimiento clonal de células
- Multi-ómica de células únicas
- Perfilado transcriptómico espacial
Principales resultados:
- La persistencia del VIH-1 se mantiene por algo más que la simple latencia viral.
- La expansión clonal, los programas de supervivencia intrínsecos a las células, la evasión inmune y los santuarios tisulares protectores contribuyen al mantenimiento del reservorio.
- Ningún factor por sí solo explica completamente la persistencia del VIH-1; interactúan múltiples mecanismos.
Conclusiones:
- La persistencia del VIH-1 resulta de una red multicapa que involucra latencia viral, proliferación clonal, supervivencia/evasión inmune celular y biología de santuarios tisulares.
- La arquitectura interconectada de estos mecanismos, no un solo factor, subyace a los reservorios persistentes de VIH-1.
- Esta comprensión integral es crucial para desarrollar estrategias novedosas para erradicar el reservorio de VIH-1.
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