Cat and Mouse: HIV Transcription in Latency, Immune Evasion and Cure/Remission Strategies

• Published in: Viruses 2019-03, Vol.11 (3), p.269
• Main Authors: Delannoy, Aurélie, Poirier, Mikaël, Bell, Brendan
• Format: Article
• Language: English
• Subjects: Animals; Anti-Retroviral Agents - therapeutic use; Antiretroviral therapy; CD4-Positive T-Lymphocytes; Clinical Trials as Topic; cure; Dendritic cells; Disease Models, Animal; Disease Reservoirs - virology; Gene expression; HIV; HIV Infections - drug therapy; HIV Infections - immunology; HIV-1 - drug effects; HIV-1 - genetics; Human immunodeficiency virus; Humans; Immune Evasion; Immune response; Immunosurveillance; Immunotherapy; Infections; Latency; Latent infection; Lymphatic system; Lymphocytes; Nervous system; Remission; Review; Transcription; Transcription, Genetic; Virus Latency - immunology
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v11030269

There is broad scientific and societal consensus that finding a cure for HIV infection must be pursued. The major barrier to achieving a cure for HIV/AIDS is the capacity of the HIV virus to avoid both immune surveillance and current antiretroviral therapy (ART) by rapidly establishing latently infected cell populations, termed latent reservoirs. Here, we provide an overview of the rapidly evolving field of HIV cure/remission research, highlighting recent progress and ongoing challenges in the understanding of HIV reservoirs, the role of HIV transcription in latency and immune evasion. We review the major approaches towards a cure that are currently being explored and further argue that small molecules that inhibit HIV transcription, and therefore uncouple HIV gene expression from signals sent by the host immune response, might be a particularly promising approach to attain a cure or remission. We emphasize that a better understanding of the game of "cat and mouse" between the host immune system and the HIV virus is a crucial knowledge gap to be filled in both cure and vaccine research.