What is a Latent HIV Reservoir?

From AIDSinfo.net, a program of the US Department of Health and Human Services

From PHN Issue 40, Summer/Fall 2019

Key Points

  • A latent HIV reservoir is a group of immune cells in the body that are infected with HIV but are not actively producing new HIV.
  • Finding ways to target and destroy latent reservoirs is a major challenge facing HIV researchers. Researchers are exploring different strategies for clearing out reservoirs.

What is a latent HIV reservoir?
A latent HIV reservoir is a group of immune cells in the body that are infected with HIV but are not actively producing new HIV. HIV attacks immune system cells in the body and uses the cells’ machinery to make copies of itself. However, some HIV-infected immune cells go into a resting (or latent) state. While in this resting state, the infected cells don’t produce new HIV. HIV can hide out inside these cells for years, forming a latent HIV reservoir. At any time, cells in the latent reservoir can become active again and start making more HIV.

Do HIV medicines work against latent HIV reservoirs?
HIV medicines prevent HIV from multiplying, which reduces the amount of HIV in the body (called the viral load). Because the HIV-infected cells in a latent reservoir aren’t producing new copies of the virus, HIV medicines have no effect on them. People with HIV must take a daily combination of HIV medicines (called an HIV treatment regimen) to keep their viral loads low. If a person stops taking their HIV medicines, the infected cells of the latent reservoir can begin making HIV again and the person’s viral load will increase. That’s why it’s important to continue taking HIV medicines every day as prescribed, even when viral load levels are low.

Are researchers studying ways to target latent HIV reservoirs?
Finding ways to target and destroy latent reservoirs is a major challenge facing HIV researchers. Researchers are exploring different strategies for clearing out reservoirs, including: Using gene therapy (which means manipulating genes to treat or prevent
disease) to cut out certain HIV genes and inactivate the virus in HIV-infected immune cells. Developing drugs or other methods to reactivate latent HIV so that the HIV can be destroyed by the immune system or new HIV therapies. This means of eliminating latent HIV reservoirs is sometimes known as the “shock and kill” or “kick and kill” strategy.

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