Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
Department of Immunology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
Cell Mol Life Sci. 2022 Jul 6;79(8):400. doi: 10.1007/s00018-022-04421-z.
Although combination antiretroviral therapy (ART) has reduced mortality and improved lifespan for people living with HIV, it does not provide a cure. Patients must be on ART for the rest of their lives and contend with side effects, unsustainable costs, and the development of drug resistance. A cure for HIV is, therefore, warranted to avoid the limitations of the current therapy and restore full health. However, this cure is difficult to find due to the persistence of latently infected HIV cellular reservoirs during suppressive ART. Approaches to HIV cure being investigated include boosting the host immune system, genetic approaches to disable co-receptors and the viral genome, purging cells harboring latent HIV with latency-reversing latency agents (LRAs) (shock and kill), intensifying ART as a cure, preventing replication of latent proviruses (block and lock) and boosting T cell turnover to reduce HIV-1 reservoirs (rinse and replace). Since most people living with HIV are in Africa, methods being developed for a cure must be amenable to clinical trials and deployment on the continent. This review discusses the current approaches to HIV cure and comments on their appropriateness for Africa.
虽然联合抗逆转录病毒疗法（ART）降低了艾滋病毒感染者的死亡率并延长了他们的寿命，但它并不能治愈艾滋病。患者必须终生接受 ART 治疗，并应对副作用、不可持续的成本和耐药性的发展。因此，需要治愈艾滋病，以避免当前疗法的局限性并恢复完全健康。然而，由于在抑制性 ART 期间潜伏感染的 HIV 细胞储库的持续存在，治愈艾滋病的方法很难找到。正在研究的 HIV 治愈方法包括增强宿主免疫系统、利用基因方法使辅助受体和病毒基因组失活、使用潜伏逆转剂（LRAs）清除潜伏 HIV 感染的细胞（休克和杀伤）、强化 ART 作为一种治愈方法、阻止潜伏前病毒的复制（阻断和锁定）以及增强 T 细胞更新以减少 HIV-1 储库（冲洗和替换）。由于大多数艾滋病毒感染者在非洲，因此正在开发的治愈方法必须适合在非洲进行临床试验和部署。这篇综述讨论了目前艾滋病治愈的方法，并对它们在非洲的适用性进行了评论。
