Cellular and anatomical reservoirs of HIV-1 in patients receiving potent antiretroviral combination therapy

The eradication of human immunodeficiency virus 1 (HIV-1) from infected persons is the ultimate goal of HIV therapeutic interventions. Great strides have been made in developing potent antiretroviral regimens that greatly suppress HIV-1 replication. Despite these therapeutic advances, major obstacles remain to eradicating HIV-1. Reservoirs of HIV-1 have been identified that represent major impediments to eradication. Conceptually, there are 2 types of Sanctuaries for HIV-1, cellular and anatomical. Cellular sanctuaries may include latent CD4(+) T cells containing integrated HIV-1 provirus; macrophages, which may express HIV-1 for prolonged periods; and follicular dendritic cells, which may hold infectious HIV-1 on their surfaces for indeterminate lengths of time. The key anatomical reservoir for HIV-1 appears to be the central nervous system. An understanding of the nature of HIV within these reservoirs is critical to devising strategies to hasten viral eradication.