UNC HIV Cure Center, Department of Medicine, and Microbiology and Immunology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Department of Epidemiology, University of North Carolina at Chapel Hill School of Public Health, Chapel Hill, NC, USA.
Methods Mol Biol. 2022;2407:375-389. doi: 10.1007/978-1-0716-1871-4_25.
Efforts to prevent and treat human immunodeficiency virus type 1 (HIV) infection have begun to blunt the spread of HIV infection. Potent, safe, and well-tolerated antiretroviral therapy (ART) allows those infected with HIV to attain a life expectancy similar to that of HIV-uninfected individuals. But the persistence of the quiescent retroviral genome, enforced by the natural proliferative responses of the immune system itself, and a delicate balance of regulators viral expression, mandates lifelong ART suppression to prevent rebound viremia and the return of disease.The approach to HIV eradication that has been studied the most extensively envisions adding therapies to induce the expression of quiescent HIV-1 genomes following the control of viremia by ART, paired with immunotherapies to clear persistent infection. Paired testing of latency reversal and clearance strategies has begun, but the field is still in its infancy and additional obstacles to HIV eradication may emerge. However, there is reason for optimism that together with advances in ART delivery and HIV prevention strategies, efforts in HIV cure research will markedly diminish the effect of the HIV pandemic on society.
预防和治疗人类免疫缺陷病毒 1 型(HIV)感染的努力已经开始遏制 HIV 感染的传播。有效的、安全的、耐受性良好的抗逆转录病毒疗法(ART)使 HIV 感染者能够达到与未感染 HIV 个体相似的预期寿命。但是,由免疫系统自身的自然增殖反应强制实施的休眠逆转录病毒基因组的持久性,以及病毒表达的调节剂的微妙平衡,需要终生进行 ART 抑制,以防止病毒血症反弹和疾病复发。研究最多的 HIV 根除方法设想在通过 ART 控制病毒血症后,增加诱导休眠 HIV-1 基因组表达的疗法,并结合免疫疗法清除持续性感染。潜伏逆转和清除策略的联合检测已经开始,但该领域仍处于起步阶段,HIV 根除可能会出现其他障碍。然而,有理由乐观地认为,随着 ART 输送和 HIV 预防策略的进步,HIV 治愈研究的努力将显著降低 HIV 大流行对社会的影响。