Human immunodeficiency virus reservoir might be actively eradicated as residual malignant cells by cytotoxic chemotherapy

A unique characteristic of human immunodeficiency virus (HIV) infection is that the virus must incorporate its cDNA into the host genomic DNA for replication. Once the virus gets into the host genome and becomes a part of the host genetic materials, elimination of the virus without killing the infected cells is virtually impossible. The use of highly active antiretroviral therapy (HAART) can result in a substantial decline in viremia. However, HAART does not eradicate HIV. The progressive HIV infection wilt unavoidably rebound after a cessation of the treatment. Searching for a new combination therapeutic strategy with cytotoxic agents that eliminate or significantly reduce the HIV reservoir is a potential way for better control of the disease. Theoretically, the HIV reservoir can be gradually eradicated by long-term use of certain antimetabolic cytotoxic drugs coupled with proper activation of latently infected cells, if viral replication is completely blocked by antiretroviral chemotherapy to protect uninfected, susceptible cells. (C) 2003 Elsevier Ltd. All rights reserved.