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Cellular reservoirs include resting memory CD4+ T lymphocytes, implicated as the major HIV reservoir, having a half\u2010life of approximately 44\u00a0months while this is less than 6\u00a0hours for HIV in plasma. In some individuals, persistent viremia consists of invariant HIV clones not detected in circulating resting CD4+ T lymphocytes suggesting other possible sources of residual viremia. Some anatomical reservoirs that may harbor such cells include the brain and the central nervous system, the gastrointestinal tract and the gut\u2010associated lymphoid tissue and other lymphoid organs, and the genital tract. The presence of immune cells and other HIV susceptible cells, occurring in differing compositions in anatomical reservoirs, coupled with variable and poor drug penetration that results in suboptimal drug concentrations in some sites, are all likely factors that fuel the continued low\u2010level replication and persistent viremia during treatment. Latently, HIV\u2010infected CD4+ T cells harboring replication\u2010competent virus, HIV cell\u2010to\u2010cell spread, and HIV\u2010infected T cell homeostatic proliferation due to chronic immune activation represent further drivers of this persistent HIV viremia during highly active antiretroviral therapy.<\/jats:p>","DOI":"10.1002\/rmv.1924","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T14:35:01Z","timestamp":1485527701000},"source":"Crossref","is-referenced-by-count":69,"title":["Mechanisms of <scp>HIV<\/scp> persistence in <scp>HIV<\/scp> reservoirs"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7262-1901","authenticated-orcid":false,"given":"Mayibongwe L.","family":"Mzingwane","sequence":"first","affiliation":[{"name":"Department of Medical Virology, Faculty of Health Sciences University of Pretoria  Pretoria South Africa"},{"name":"Department of Pathology, Faculty of Medicine National University of 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