From the Epidemiology Branch (Dr Schrager) and the Pathogenesis and Basic Research Branch (Dr D'Souza), Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Md.
The eradication of human immunodeficiency virus 1 (HIV-1) from infected
persons is the ultimate goal of HIV therapeutic interventions. Great strides
have been made in developing potent antiretroviral regimens that greatly suppress
HIV-1 replication. Despite these therapeutic advances, 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 and anatomical. Cellular sanctuaries may include latent
CD4+ T cells containing integrated HIV-1 provirus; macrophages,
which may express HIV-1 for prolonged periods; and follicular dendritic cells,
which may hold infectious HIV-1 on their surfaces for indeterminate lengths
of time. The key anatomical reservoir for HIV-1 appears to be the central
nervous system. An understanding of the nature of HIV within these reservoirs
is critical to devising strategies to hasten viral eradication.
Schrager LK, D'Souza MP. Cellular and Anatomical Reservoirs of HIV-1 in Patients Receiving Potent Antiretroviral Combination Therapy. JAMA. 1998;280(1):67-71. doi:10.1001/jama.280.1.67