Finding a Cure for HIV: Much Work to Do
Authors: Sharon R. Lewin
Journal: Annals of Internal Medicine (2014)

Editorials2 September 2014Finding a Cure for HIV: Much Work to DoSharon R. Lewin, FRACP, PhDSharon R. Lewin, FRACP, PhDFrom Alfred Health, Monash University, and Burnet Institute, Melbourne, Victoria, Australia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-1573 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Antiretroviral therapy (ART) for HIV infection was one of the most spectacular scientific advances in recent decades. Patients who initiate ART at the right time can now have a normal life expectancy, and ART also dramatically reduces the risk for HIV transmission. However, treatment is not perfect. Lifelong ART is required, there are associated short- and long-term toxicities, and the drugs and health systems required to keep persons in long-term care come at a considerable cost (1). Therefore, there is a significantly renewed effort to find a cure for HIV (or a way to put HIV into remission) so patients ...References1. Maartens G, Celum C, Lewin SR. HIV infection: epidemiology, pathogenesis, treatment, and prevention. Lancet. 2014. [PMID: 24907868] doi:10.1016/S0140-6736(14)60164-1 CrossrefMedlineGoogle Scholar2. Chun TW, Carruth L, Finzi D, Shen X, DiGiuseppe JA, Taylor H, et al. Quantification of latent tissue reservoirs and total body viral load in HIV-1 infection. Nature. 1997;387:183-8. [PMID: 9144289] CrossrefMedlineGoogle Scholar3. Maldarelli F, Wu X, Su L, Simonetti FR, Shao W, Hill S, et al. Specific HIV integration sites are linked to clonal expansion and persistence of infected cells. Science. 2014. [PMID: 24968937] CrossrefMedlineGoogle Scholar4. Henrich TJ, Hanhauser E, Marty FM, Sirignano MN, Keating S, Lee TH, et al. Antiretroviral-free HIV-1 remission and viral rebound after allogeneic stem cell transplantation: report of 2 cases. Ann Intern Med. 2014;161:319-27. doi:10.7326/M14-1027 LinkGoogle Scholar5. 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] doi:10.1056/NEJMoa0802905 CrossrefMedlineGoogle Scholar6. Yukl SA, Boritz E, Busch M, Bentsen C, Chun TW, Douek D, et al. Challenges in detecting HIV persistence during potentially curative interventions: a study of the Berlin patient. PLoS Pathog. 2013;9:e1003347. [PMID: 23671416] doi:10.1371/journal.ppat.1003347 CrossrefMedlineGoogle Scholar7. National Institute of Allergy and Infectious Diseases. “Mississippi Baby” now has detectable HIV, researchers find [news release]. Bethesda, MD: National Institute of Allergy and Infectious Diseases; 10 July 2014. Accessed at www.niaid.nih.gov/news/newsreleases/2014/Pages/MississippiBabyHIV.aspx on 10 July 2014. Google Scholar8. Cillo AR, Krishnan S, McMahon DK, Mitsuyasu RT, Para MF, Mellors JW. Impact of chemotherapy for HIV-1 related lymphoma on residual viremia and cellular HIV-1 DNA in patients on suppressive antiretroviral therapy. PLoS One. 2014;9:e92118. [PMID: 24638072] doi:10.1371/journal.pone.0092118 CrossrefMedlineGoogle Scholar9. Stock PG, Barin B, Hatano H, Rogers RL, Roland ME, Lee TH, et al; Solid Organ Transplantation in HIV Study Investigators. Reduction of HIV persistence following transplantation in HIV-infected kidney transplant recipients. Am J Transplant. 2014;14:1136-41. [PMID: 24698537] doi:10.1111/ajt.12699 CrossrefMedlineGoogle Scholar10. Markey KA, MacDonald KP, Hill GR. The biology of graft-versus-host disease: experimental systems instructing clinical practice. Blood. 2014. [PMID: 24914137] CrossrefMedlineGoogle Scholar11. Tebas P, Stein D, Tang WW, Frank I, Wang SQ, Lee G, et al. Gene editing of CCR5 in autologous CD4 T cells of persons infected with HIV. N Engl J Med. 2014;370:901-10. [PMID: 24597865] doi:10.1056/NEJMoa1300662 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Alfred Health, Monash University, and Burnet Institute, Melbourne, Victoria, Australia.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1573.Corresponding Author: Sharon R. Lewin, FRACP, PhD, Department of Infectious Diseases, Alfred Hospital, Level 2, Burnet Building, 85 Commercial Road, Melbourne, Victoria 3004, Australia; e-mail, s.[email protected]org.au.This article was published online first at www.annals.org on 22 July 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntiretroviral-Free HIV-1 Remission and Viral Rebound After Allogeneic Stem Cell Transplantation Timothy J. Henrich , Emily Hanhauser , Francisco M. Marty , Michael N. Sirignano , Sheila Keating , Tzong-Hae Lee , Yvonne P. Robles , Benjamin T. Davis , Jonathan Z. Li , Andrea Heisey , Alison L. Hill , Michael P. Busch , Philippe Armand , Robert J. Soiffer , Marcus Altfeld , and Daniel R. Kuritzkes Antiretroviral-Free HIV-1 Remission and Viral Rebound After Allogeneic Stem Cell Transplantation Timothy J. Henrich , Emily Hanhauser , Francisco M. Marty , Michael N. Sirignano , Sheila Keating , Tzong-Hae Lee , Yvonne P. Robles , Benjamin T. Davis , Jonathan Z. Li , Andrea Heisey , Alison L. Hill , Michael P. Busch , Philippe Armand , Robert J. Soiffer , Marcus Altfeld , and Daniel R. Kuritzkes Metrics Cited ByEstablishment of a Novel Humanized Mouse Model To Investigate In Vivo Activation and Depletion of Patient-Derived HIV Latent ReservoirsTowards a scalable HIV cure research agenda: the role of co-infectionsExperiences and expectations of participants completing an HIV cure focused clinical trialHIV Cure Strategies: How Good Must They Be to Improve on Current Antiretroviral Therapy? 2 September 2014Volume 161, Issue 5Page: 368-369KeywordsAntiretroviral therapyCellsDNAHIVHIV infectionsImmune responseImmune systemT cellsToxicityTransplantation ePublished: 2 September 2014 Issue Published: 2 September 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...