Residual Proviral Reservoirs: A High Risk for HIV Persistence and Driving Forces for Viral Rebound after Analytical Treatment Interruption

Viruses. 2021 Feb 21;13(2):335. doi: 10.3390/v13020335.

Abstract

Antiretroviral therapy (ART) has dramatically suppressed human immunodeficiency virus (HIV) replication and become undetectable viremia. However, a small number of residual replication-competent HIV proviruses can still persist in a latent state even with lifelong ART, fueling viral rebound in HIV-infected patient subjects after treatment interruption. Therefore, the proviral reservoirs distributed in tissues in the body represent a major obstacle to a cure for HIV infection. Given unavailable HIV vaccine and a failure to eradicate HIV proviral reservoirs by current treatment, it is crucial to develop new therapeutic strategies to eliminate proviral reservoirs for ART-free HIV remission (functional cure), including a sterilizing cure (eradication of HIV reservoirs). This review highlights recent advances in the establishment and persistence of HIV proviral reservoirs, their detection, and potential eradication strategies.

Keywords: HIV; SIV; cell-associated viral reservoir; proviral reservoir.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Anti-Retroviral Agents / therapeutic use
  • DNA, Viral / genetics
  • DNA, Viral / metabolism
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV-1 / genetics*
  • Humans
  • Proviruses / genetics*
  • Proviruses / physiology
  • Viral Load
  • Virus Latency

Substances

  • Anti-Retroviral Agents
  • DNA, Viral