A Review of the Advances in the Mechanisms used to Mitigate/Reverse HIV Latency

When HIV infects host immune cells, it inserts its genetic material into their DNA enabling the virus to use the cell's machinery to make copies of itself. Antiretroviral therapy for patients living with HIV results in successful viral suppression. Drug therapy doesn't however, lead to full eradication of infection and the virus continues to persist within a latent reservoir in resting memory CD4+ T cells and macrophages where the virus can hide for a long time without their genetic code being read to make protein, thus eluding the immune system's response and antiviral treatments. HIV infected patients must therefore stay on the drugs for life because once taken off therapy or if treatment fails, the virus hiding in the dormant host cells becomes reactivated and massively proliferates leading to disease progression. Overcoming latent virus reservoir remains the most significant obstacle to HIV cure. The focus in HIV/AIDS research is now turned toward the eradication of the virus in the latent reservoirs or silencing it by preventing its reactivation. However, therapeutic strategies to reactivate latent HIV-infected cells have so far remained elusive, because latency reversing agents either appear to lack sufficient potency or could trigger massive immune system activation which itself could be deadly. This review discusses recently researched mechanisms that could be used to reverse HIV latency or silence the latent virus as well as other approaches towards tackling HIV latency including biological control of HIV reservoirs; immunotherapy as well as seeking a better understanding of the science of latency.