CELLULAR AND ANATOMICAL RESERVOIRS OF HIV-1 IN PATIENTS RECEIVING POTENT ANTIRETROVIRAL COMBINATION THERAPY

The eradication of human immunodeficiency virus 1 (HIV-1) from infecte d persons is the ultimate goal of HIV therapeutic interventions. Great strides have been made in developing potent antiretroviral regimens t hat greatly suppress HIV-1 replication. Despite these therapeutic adva nces, major obstacles remain to eradicating HIV-1. Reservoirs of HIV-1 have been identified that represent major impediments to eradication. Conceptually, there are 2 types of Sanctuaries for HIV-1, cellular an d anatomical. Cellular sanctuaries may include latent CD4(+) T cells c ontaining integrated HIV-1 provirus; macrophages, which may express HI V-1 for prolonged periods; and follicular dendritic cells, which may h old infectious HIV-1 on their surfaces for indeterminate lengths of ti me. The key anatomical reservoir for HIV-1 appears to be the central n ervous system. An understanding of the nature of HIV within these rese rvoirs is critical to devising strategies to hasten viral eradication.