Latent reservoirs of HIV: Obstacles to the eradication of virus

The use of highly active antiretroviral therapy (HAART) in the treatment of HIV-l-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 attributable to AIDS. Nonetheless, the persistence of reservoirs of HIV, including latently infected, resting CD4(+) T cells that can give rise to infectious HIV upon stimulation in vitro, has posed a sobering challenge to the long-term control or eradication of HIV in infected individuals receiving HAART. Although a recent study has demonstrated that the size of the pool of latently infected, resting CD4(+) T cells can be markedly diminished with intermittent interleukin (IL)-2 and continuous HAART, complete eradication of HIV in infected individuals remains extremely problematic. Here, we discuss recent developments in studies of the latent reservoir of HIV in patients receiving HAART and implications for the long-term treatment of infected individuals and eradication of the infection.