HIV Cure: How Far We Have Come?

Abstract

Human Immunodeficiency Virus (HIV) is a major global healthcare burden. Current lifelong antiretroviral therapy drastically improves life expectancy but do not cure HIV. Therefore, at the existing growth rates, it is estimated that around 42 million people will be living with HIV by 2030 worldwide. A cure for HIV is need of the hour which could come in the form of remission (durable viral control without ART) or eradication (complete removal of latent replication-competent virus). In this review, we discuss recent advances in basic, applied and clinical aspects of latent HIV reservoirs including its tissue locations, cell types, cell properties, genomic integration sites and its significance, mechanism of reservoir seeding and methods to study the reservoirs. Natural models of functional cure which include elite controllers, viremic controllers, long term non-progressors and post-treatment controllers are discussed. Recent advances towards a functional HIV cure are discussed under headings; CCR5Δ32/Δ32 stem cells transplantation, shock and kill strategy, block and lock strategy, gene therapy and combined strategies.