Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Infect Dis. 2021 Feb 15;223(12 Suppl 2):4-12. doi: 10.1093/infdis/jiaa568.
Antiretroviral therapy effectively controls human immunodeficiency virus (HIV) replication but it is unable to fully eradicate the HIV reservoir and treatment must be life-long. Progress toward a strategy for HIV remission will require overcoming key hurdles to fill gaps in our understanding of HIV persistence, but the identification of individuals who have attained sterilizing or functional HIV cure show that such a goal is achievable. In this review, we first outline challenges in targeting the HIV reservoir, including difficulties identifying HIV-infected cells, ongoing work elucidating the complex intracellular environment that contribute to HIV latency, and barriers to reactivating and clearing the HIV reservoir. We then review reported cases of HIV sterilizing cure and explore natural models of HIV remission and the promise that such HIV spontaneous and posttreatment controllers may hold in our search for a broadly-applicable strategy for the millions of patients living with HIV.
抗逆转录病毒疗法可有效控制人类免疫缺陷病毒（HIV）复制，但无法完全清除 HIV 储存库，因此治疗必须是终身的。要实现 HIV 缓解的策略，就需要克服关键障碍，填补我们对 HIV 持续存在的理解空白，但鉴定出已达到根治或功能性 HIV 治愈的个体表明，这一目标是可以实现的。在这篇综述中，我们首先概述了针对 HIV 储存库的靶向治疗所面临的挑战，包括鉴定 HIV 感染细胞的困难、阐明导致 HIV 潜伏期的复杂细胞内环境的持续工作，以及重新激活和清除 HIV 储存库的障碍。然后，我们回顾了 HIV 根治性治愈的报道病例，并探讨了 HIV 自然缓解的模型，以及此类 HIV 自发性和治疗后控制者在我们寻找适用于数百万 HIV 感染者的广泛应用策略方面的潜力。
