Latent Reservoirs of HIV: Perspectives for Eradication and Development of Therapeutic Strategies

Tae-Wook Chun, Ph.D.

Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 (USA)

The use of highly active antiretroviral therapy (HAART) in the treatment of HIV-1 infected individuals has provided a considerable amount of information regarding the dynamics of viral replication and has resulted in enormous advances in HIV therapeutics. The profound suppression of plasma viremia in HIV-infected individuals receiving HAART has resulted in a highly beneficial clinical effect and a dramatic decrease in the death rate due to AIDS. Nonetheless, the existence of latently infected, resting CD4⁺ T cells that can give rise to infectious HIV upon stimulation in vitro has posed one of the greatest challenges to the long-term control or eradication of HIV in infected individuals receiving HAART. It also has become clear that HIV persistently replicates even in infected patients whose levels of plasma viremia have fallen below detectable levels while on HAART. Recent data from our laboratory regarding the above issues will be discussed, together with the pathophysiologic impact of active HIV replication on the latent viral reservoir.