HIV Cure: The Target Is Clearer but Not Yet Close
Authors: Paul Volberding
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions1 April 2014HIV Cure: The Target Is Clearer but Not Yet ClosePaul Volberding, MDPaul Volberding, MDFrom University of California, San Francisco, San Francisco, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2893 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The world desperately needs an HIV cure, but recent news is not promising. Of the millions of persons chronically infected since the epidemic's emergence, only 1 is alive and free of the virus, and we now know that HIV has reemerged in 2 more persons previously believed to have been cured. Where do we stand now, and where is there room for optimism?Compared with most infectious agents, HIV seems uniquely designed to persist in its host and be transmitted. The natural immune response does not control HIV as it establishes a chronic infection, which helps explain the frustration in ...References1. Finzi D, Hermankova M, Pierson T, Carruth LM, Buck C, Chaisson RE, et al. Identification of a reservoir for HIV-1 in patients on highly active antiretroviral therapy. Science. 1997;278:1295-300. [PMID: 9360927] CrossrefMedlineGoogle Scholar2. Rosenberg ES, Altfeld M, Poon SH, Phillips MN, Wilkes BM, Eldridge RL, et al. Immune control of HIV-1 after early treatment of acute infection. Nature. 2000;407:523-6. [PMID: 11029005] CrossrefMedlineGoogle Scholar3. Lifson AR, Buchbinder SP, Sheppard HW, Mawle AC, Wilber JC, Stanley M, et al. Long-term human immunodeficiency virus infection in asymptomatic homosexual and bisexual men with normal CD4+ lymphocyte counts: immunologic and virologic characteristics. J Infect Dis. 1991;163:959-65. [PMID: 1673465] CrossrefMedlineGoogle Scholar4. Hunt PW, Brenchley J, Sinclair E, McCune JM, Roland M, Page-Shafer K, et al. Relationship between T cell activation and CD4+ T cell count in HIV-seropositive individuals with undetectable plasma HIV RNA levels in the absence of therapy. J Infect Dis. 2008;197:126-33. [PMID: 18171295] CrossrefMedlineGoogle Scholar5. Hocqueloux L, Prazuck T, Avettand-Fenoel V, Lafeuillade A, Cardon B, Viard JP, et al. Long-term immunovirologic control following antiretroviral therapy interruption in patients treated at the time of primary HIV-1 infection. AIDS. 2010;24:1598-601. [PMID: 20549847] CrossrefMedlineGoogle Scholar6. Hütter G, Nowak D, Mossner M, Ganepola S, Müssig A, Allers K, et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. N Engl J Med. 2009;360:692-8. [PMID: 19213682] CrossrefMedlineGoogle Scholar7. Henrich TJ, Hu Z, Li JZ, Sciaranghella G, Busch MP, Keating SM, et al. Long-term reduction in peripheral blood HIV type 1 reservoirs following reduced-intensity conditioning allogeneic stem cell transplantation. J Infect Dis. 2013;207:1694-702. [PMID: 23460751] CrossrefMedlineGoogle Scholar8. Henrich TJ. Challenges and strategies towards functional cure: how low do you need to go? Presented at the Sixth International Workshop on HIV Persistence during Therapy, Miami, Florida, 3–6 December 2013. Google Scholar9. Lawitz E, Mangia A, Wyles D, Rodriguez-Torres M, Hassanein T, Gordon SC, et al. Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med. 2013;368:1878-87. [PMID: 23607594] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Paul Volberding, MDAffiliations: From University of California, San Francisco, San Francisco, California.Grant Support: By the Center for AIDS Research grant (P30 AI027763) from the National Institutes of Health and University of California, San Francisco–Gladstone Institute of Virology & Immunology Center for AIDS Research.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2893.Corresponding Author: Paul Volberding, MD, AIDS Research Institute at University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105.Author Contributions: Conception and design: P. Volberding.Analysis and interpretation of the data: P. Volberding.Drafting of the article: P. Volberding.Critical revision of the article for important intellectual content: P. Volberding.Final approval of the article: P. Volberding.This article was published online first at www.annals.org on 14 January 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLessons Learned From Failures and Success Stories of HIV Breakthroughs: Are We Getting Closer to an HIV Cure?What motivates participation in HIV cure trials? A call for real-time assessment to improve informed consentThe Ethics of HIV “Cure” Research: What Can We Learn from Consent Forms? 1 April 2014Volume 160, Issue 7Page: 505-506KeywordsAIDSAntiretroviralsBone marrow transplantationCellsChemotherapyDrugsHIVHIV infectionsTransplantationVaccines ePublished: 1 April 2014 Issue Published: 1 April 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...