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HIV

Early treatment may not be early enough

Nature volume 512, pages 35–36 (2014)Cite this article

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Giving monkeys antiretroviral therapy from just three days after exposure to simian immunodeficiency virus does not prevent a subsequent rebound of viral replication, suggesting that viral reservoirs are established early. See Letter p.74

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 state1,2,3,4. In these immune cells, called resting memory CD4+ T cells, the viral genome hides as pure genetic information integrated into the cells' DNA (as proviral 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 infection5. 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.6 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.

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Figure 1: SIV eradication strategies.

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Authors and Affiliations

  1. Kai Deng and Robert F. Siliciano are in the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.,

    Kai Deng & Robert F. Siliciano

  2. R.F.S. is also at the Howard Hughes Medical Institute, Baltimore.,

    Robert F. Siliciano

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  1. Kai Deng
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  2. Robert F. Siliciano
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Correspondence to Robert F. Siliciano.

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Deng, K., Siliciano, R. Early treatment may not be early enough. Nature 512, 35–36 (2014). https://doi.org/10.1038/nature13647

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