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HIV induces persistent infection and, despite improvements in mortality and morbidity conferred by Highly Active Antiretroviral Therapy (HAART), there is currently no cure [1]. The immune system controls HIV only partially, and plasma HIV and proviral DNA can be detected from acute primary infection to end-stage AIDS [2]. More than 99% of HIV replication has been demonstrated in activated and infected CD4+ T-cells [3]. These are the very cells that are instrumental in the clearance of virus through the host’s adaptive immune response. Gradually, throughout the course of infection, repeated rounds of CD4+ T cell infection lead to an overall and marked decrease in the total number of CD4+ T cells [4] and this has been linked to the clinical manifestations of HIV disease [5]. HIV-1 replicates rapidly in infected patients, with a virion half-life of less than 6 hours in plasma [6], and a half-life of 1-2 days in proliferating infected cells [7] [8] [9], corresponding to the short-lived population that produces most of the HIV-1 The major problem with eradication of HIV lies with the existence of a pool of latently infected cells. Retroviral latency occurs when a provirus infects and integrates into the genomic DNA of its target cell, but is transcriptionally silent [10]. These cells are able to persistently produce infectious HIV virions when activated, even from patients on highly active antiretroviral therapy (HAART), and are a potential source of rebounded virus after HAART treatment is interrupted [3]. There are myriad cells and tissue types in which HIV can integrate, and it is at these sites that the long-term preservation of replication-competent HIV can occur [11]. Infectious virus within HIV reservoirs has a longer half life than the virus in cells where there is active viral replication [12]. The half life of the viral reservoir has been estimated at 43.9 months during three years of HAART, [13] and 44.2 months whilst on seven years of HAART [14]. Thus, it had been estimated to take possibly as long as 60 years to eradicate the virus using HAART alone [13]. In other studies , the reservoir half life in patients with optimal suppression of viral replication was estimated to be as little as 6 months [15] [16].

Characterisation, Evaluation and Clinical Significance of Latent HIV-1 Reservoirs and Therapeutic Strategies for HIV Eradication