The effects of interleukin-2 therapy on the viral reservoir in HIV plus patients

The initial idea that potent antiretroviral therapies could eradicate HIV i nfection within a few years of treatment has been recently challenged by th e demonstration that the viral reservoir persists in the peripheral blood a nd in the lymphoid tissue. For this reason, an alternative approach based o n the use of interleukin-2 has been developed. This cytokine, in fact, may be able to activate infected cells, promoting viral integration and replica tion, making HIV susceptible to antiretroviral treatments; this fact may ul timately contribute to the eradication of the virus itself. The measurement of the viral reservoir appears therefore essential to monitor the effects of combination therapies. We summarize here the technical approaches that h ave been used to quantitatively assess the HIV reservoir. We also show that the prolonged use of IL-2 in association with antiretroviral drugs promote s a reduction of the viral reservoir, but is unable to eradicate HIV, even after two years of therapy. The available in vitro and in vivo data do not exclude the fact that IL-2 may have a future in the treatment of HIV infect ion, though new therapeutic approaches using different strategies are requi red to clarify this issue. (C) 2000 Editions scientifiques et medicales Els evier SAS.