Early treatment may not be early enough

摘要

Although antiretroviral therapy (ART) is successful in controlling HIV-1 replication, the virus persists in a stable latent reservoir in infected cells that have entered a resting state. In these immune cells, called resting memory CD4~+ T cells, the viral genome hides as pure genetic information integrated into the cells' DNA (as pro-viral DNA), unaffected by ART or immune responses. But when the cells are subsequently activated, this viral reservoir again releases replication-competent HIV-1, and it is therefore considered the main barrier to curing HIV-1 infection. Despite vigorous efforts to understand the latent reservoir in the hope of finding ways to purge it, it has been unclear when it is seeded and whether early treatment can prevent this. On page 74 of this issue, Whitney et al. provide evidence in the simian immunodeficiency virus (SIV) model of HIV-1 infection that the reservoir is seeded very early - during the first few days of infection.