Early Combination Antiretroviral Therapy Limits HIV-1 Persistence in Children

Annu Rev Med. 2016;67:201-13. doi: 10.1146/annurev-med-091114-111159.

Abstract

Globally, 240,000 infants are newly infected with HIV-1 each year and 3.2 million children are living with the infection. Combination antiretroviral therapy (cART) has reduced HIV-1-related disease and mortality in children but is not curative owing to the early generation of a latent reservoir of long-lived memory CD4(+) T cells bearing replication-competent HIV-1 provirus integrated into cellular DNA. This review focuses on recent advances in our understanding of the establishment of HIV-1 persistence in children and how early initiation of cART in the setting of the developing infant immune system limits the formation of the long-lived latent CD4(+) cell reservoir that remains a barrier to remission or cure.

Keywords: HIV-1 remission; latent reservoirs; pediatric HIV-1.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • CD4-Positive T-Lymphocytes / virology*
  • Drug Therapy, Combination
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Infections / virology
  • HIV-1* / genetics
  • HIV-1* / immunology
  • Humans
  • Infant
  • Secondary Prevention / methods*
  • Viral Load
  • Virus Integration*

Substances

  • Anti-HIV Agents