Paul Volberding, MD
This article was published online first at www.annals.org on 14 January 2014.
Grant Support: By the Center for AIDS Research grant (P30 AI027763) from the National Institutes of Health and University of California, San Francisco–Gladstone Institute of Virology & Immunology Center for AIDS Research.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2893.
Requests for Single Reprints: Paul Volberding, MD, AIDS Research Institute at University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105.
Author Contributions: Conception and design: P. Volberding.
Analysis and interpretation of the data: P. Volberding.
Drafting of the article: P. Volberding.
Critical revision of the article for important intellectual content: P. Volberding.
Final approval of the article: P. Volberding.
Volberding P.; HIV Cure: The Target Is Clearer but Not Yet Close. Ann Intern Med. 2014;160:505-506. doi: 10.7326/M13-2893
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Published: Ann Intern Med. 2014;160(7):505-506.
The world desperately needs an HIV cure, but recent news is not promising. Of the millions of persons chronically infected since the epidemic's emergence, only 1 is alive and free of the virus, and we now know that HIV has reemerged in 2 more persons previously believed to have been cured. Where do we stand now, and where is there room for optimism?
Compared with most infectious agents, HIV seems uniquely designed to persist in its host and be transmitted. The natural immune response does not control HIV as it establishes a chronic infection, which helps explain the frustration in developing a truly effective vaccine. Furthermore, the virus hides within the genomes of certain cells, where it is protected from elimination by otherwise potent antiretroviral drugs (1). These cells form a functional reservoir of HIV in the body that is ready to be reactivated later when, for example, therapy is discontinued (2). Despite these substantial challenges, a vigorous and collaborative worldwide search for an HIV cure is under way.
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Infectious Disease, HIV.
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