{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T04:14:33Z","timestamp":1769573673750,"version":"3.49.0"},"reference-count":84,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,1,24]],"date-time":"2011-01-24T00:00:00Z","timestamp":1295827200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:p>Combination antiretroviral therapy (cART) has led to a major reduction in HIV\u2010related mortality and morbidity. However, HIV still cannot be cured. With the absence of an effective prophylactic or therapeutic vaccine, increasing numbers of infected people, emerging new toxicities secondary to cART and the need for life\u2010long treatment, there is now a real urgency to find a cure for HIV.<\/jats:p><jats:p>There are currently multiple barriers to curing HIV. The most significant barrier is the establishment of a latent or \u201csilent\u201d infection in resting CD4+ T cells. In latent HIV infection, the virus is able to integrate into the host cell genome, but does not proceed to active replication. As a consequence, antiviral agents, as well as the immune system, are unable to eliminate these long\u2010lived, latently infected cells. Reactivation of latently infected resting CD4+ T cells can then re\u2010establish infection once cART is stopped. Other significant barriers to cure include residual viral replication in patients receiving cART, even when the virus is not detectable by conventional assays. In addition, HIV can be sequestered in anatomical reservoirs, such as the brain, gastrointestinal tract and genitourinary tract.<\/jats:p><jats:p>Achieving either a functional cure (long\u2010term control of HIV in the absence of cART) or a sterilizing cure (elimination of all HIV\u2010infected cells) remains a major challenge. Several studies have now demonstrated that treatment intensification appears to have little impact on latent reservoirs. Some potential and promising approaches that may reduce the latent reservoir include very early initiation of cART and the use of agents that could potentially reverse latent infection.<\/jats:p><jats:p>Agents that reverse latent infection will promote viral production; however, simultaneous administration of cART will prevent subsequent rounds of viral replication. Such drugs as histone deacetylase inhibitors, currently used and licensed for the treatment of some cancers, or activating latently infected resting cells with cytokines, such as IL\u20107 or prostratin, show promising results in reversing latency <jats:italic>in vitro<\/jats:italic> when used either alone or in combination. In order to move forward toward clinical trials that target eradication, there needs to be careful consideration of the risks and benefits of these approaches, agreement on the most informative endpoints for eradication studies and greater engagement of the infected community.<\/jats:p>","DOI":"10.1186\/1758-2652-14-4","type":"journal-article","created":{"date-parts":[[2011,1,25]],"date-time":"2011-01-25T07:14:09Z","timestamp":1295939649000},"page":"4-4","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Finding a cure for HIV: will it ever be achievable?"],"prefix":"10.1002","volume":"14","author":[{"given":"Sharon R","family":"Lewin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa A","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian H","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Spire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Chomont","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,1,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13802-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803263381301"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68337-2"},{"key":"e_1_2_7_5_1","unstructured":"WHO UNAIDS UNICEF:Towards universal access: scaling up priority HIV\/AIDS interventions in the health sector: Progress report2010[http:\/\/www.who.int\/hiv\/mediacentre\/universal_access_progress_report_en.pdf]."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-2-200701160-00003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283365356"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030218"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/652749"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200305230-00010"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a3172"},{"key":"e_1_2_7_12_1","unstructured":"World Health Organization:Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach.2010[http:\/\/www.who.int\/hiv\/pub\/arv\/adult2010\/en\/index.html]."},{"key":"e_1_2_7_13_1","unstructured":"Department of Health and Human Services (DHHS):Panel on Antiretroviral Guidelines for Adults and Adolescents. 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