HIV Persistence on Antiretroviral Therapy and Barriers to a Cure

Advances in Experimental Medicine and Biology
Julia Marsh Sung, David M Margolis

Abstract

HIV persists within the body despite successful suppression of virus replication with antiretroviral therapy (ART). HIV lurks in latent and active reservoirs, leading to rebound of virus spread if ART is interrupted. The latent HIV reservoir is a natural consequence of the life cycle of HIV, with integration of HIV into the genomes of cells that are or later enter the resting state, resulting in transcriptionally quiescent provirus. Resting CD4 T cells comprise the majority of the latent reservoir, although new evidence points to additional, smaller cellular reservoirs of latent HIV. An alternate, so-called active reservoir of HIV also exists within cells such as those found the B cell follicle of lymph nodes, where expression of HIV RNA can be found, again despite the full suppression of viremia and viral replication. Multiple factors such as the degree of virus exposure, timing of ART, and host factors can influence the size and characteristics of the HIV reservoir. Constructing effective strategies for HIV eradication and measuring their impact will require a sophisticated knowledge of the HIV reservoir.

Citations

Nov 12, 2019·Frontiers in Cellular and Infection Microbiology·Clementine WalletChristian Schwartz
Aug 7, 2019·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Nina Y Yuan, Marcus Kaul
Oct 21, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Rong HuNianhua Xie
Feb 16, 2021·The Journal of Infectious Diseases·Yijia LiJonathan Z Li
Oct 4, 2020·Journal of Controlled Release : Official Journal of the Controlled Release Society·Pengbo GuoHo Lun Wong
Jun 2, 2021·Virology Journal·Sepideh SaebChristian Schwartz
Jul 29, 2021·PLoS Computational Biology·Jonathan W CodyElsje Pienaar
Aug 28, 2021·Biomedicines·Ana Borrajo LópezRoberto Carlos Agís-Balboa

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