Open AccessCharacterizing the Latent HIV-1 Reservoir in Patients with Viremia Suppressed on cART: Progress, Challenges, and Opportunities
Author(s) -
Jason W. Rausch,
Stuart F. J. Le Grice
Publication year - 2020
Publication title -
current hiv research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.561
H-Index - 52
eISSN - 1873-4251
pISSN - 1570-162X
DOI - 10.2174/1570162x18666191231105438
Subject(s) - viremia , cart , antiretroviral therapy , human immunodeficiency virus (hiv) , immunology , medicine , virology , virus latency , immune system , viral load , biology , viral replication , virus , mechanical engineering , engineering
Modern combination antiretroviral therapy (cART) can bring HIV-1 in blood plasma to level undetectable by standard tests, prevent the onset of acquired immune deficiency syndrome (AIDS), and allow a near-normal life expectancy for HIV-infected individuals. Unfortunately, cART is not curative, as within a few weeks of treatment cessation, HIV viremia in most patients rebounds to pre-cART levels. The primary source of this rebound, and the principal barrier to a cure, is the highly stable reservoir of latent yet replication-competent HIV-1 proviruses integrated into the genomic DNA of resting memory CD4+ T cells. In this review, prevailing models for how the latent reservoir is established and maintained, residual viremia and viremic rebound upon withdrawal of cART, and the types and characteristics of cells harboring latent HIV-1 will be discussed. Selected technologies currently being used to advance our understanding of HIV latency will also be presented, as will a perspective on which areas of advancement are most essential for producing the next generation of HIV-1 therapeutics.