Alain Lafeuillade (France) and Mario Stevenson (USA) co-authored a paper on HIV reservoirs that claims these reservoirs are the main hurdle to achieving HIV eradication. While antiretroviral therapy treatments have been successful in lengthening the life expectancy for HIV-infected individuals, a cure for HIV has not been found. The cure is not within reach primarily because of HIV reservoirs. While effective, antiretroviral therapy (ART) doesn't completely wipe out the HIV infection. Persistent infection is the result of small pools of virulent material known as HIV reservoirs, and these reservoirs are preventing the progress toward an HIV cure.
HIV persistence remains, even with antiretroviral (ART) treatment. Two critical questions arise when it comes to reservoirs. The first question is figuring out how to determine the nature of non-lymphocytic HIV reservoirs; the second question is finding a possible "threshold" where the HIV reservoir is kept low enough for the body to effectively control it. However, encouraging results were made in 2010 when the first person to ever be cured of HIV infection via a stem cell transplant. While this is apparently an isolated incident, it does show that HIV is curable. This development brought widespread optimism in the scientific community.
Therefore, the goal is to improve ART treatments to deal with latent HIV reservoirs, "purging" them in a way. Research indicates that a cocktail of drugs are needed to deal with compartment of the reservoir, sterilizing the virus and making it unable to replicate. These are the usual approaches to dealing with HIV—neutralizing the virus by taking away its ability to copy itself. Gene therapy combined with stem cell research into zinc finger nucleases designed to disrupt CCR5 expression have also been useful research topics. In fact, the stem cells implanted in the HIV-cured patient came from an individual with a rare CCR5 mutation.
HIV persistence via reservoirs is a top priority for researchers and health professionals throughout the globe. This paper provides information on the mechanisms of HIV persistence and a discussion on the critical questions facing researchers in the field. It also briefly discusses the need for better ART treatments and ends with a paragraph talking about the development of a task force dedicated to dealing with this subject. While the improvements in technology and medicine have made things better for HIV patients and improved the quality of their lives, HIV persistence via reservoirs has prevented an outright cure from being developed. The hope, as stated by the paper, is to turn the isolated HIV cure incident into a regular occurrence.
About the publication: The Search for a Cure for Persistent HIV Reservoirs. AIDS Rev. 2011; 13: 63-6