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Immune Interventions to Eliminate the HIV Reservoir

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Book cover HIV-1 Latency

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 417))

Abstract

Inducing HIV remission is a monumental challenge. A potential strategy is the “kick and kill” approach where latently infected cells are first activated to express viral proteins and then eliminated through cytopathic effects of HIV or immune-mediated killing. However, pre-existing immune responses to HIV cannot eradicate HIV infection due to the presence of escape variants, inadequate magnitude, and breadth of responses as well as immune exhaustion. The two major approaches to boost immune-mediated elimination of infected cells include enhancing cytotoxic T lymphocyte mediated killing and harnessing antibodies to eliminate HIV. Specific strategies include increasing the magnitude and breadth of T cell responses through therapeutic vaccinations, reversing the effects of T cell exhaustion using immune checkpoint inhibition, employing bispecific T cell targeting immunomodulatory proteins or dual-affinity re-targeting molecules to direct cytotoxic T lymphocytes to virus-expressing cells and broadly neutralizing antibody infusions. Methods to steer immune responses to tissue sites where latently infected cells are located need to be further explored. Ultimately, strategies to induce HIV remission must be tolerable, safe, and scalable in order to make a global impact.

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Acknowledgements

This work was supported by a cooperative agreement (W81XWH-11-2-0174) between the Henry M. Jackson Foundation for the Advancement of Military Medicine Inc. and the U.S. Department of the Army. The views expressed herein are those of the authors and should not be construed to represent the positions of the Departments of the Army or Defense. Trade names are used for identification purposes only and do not imply endorsement.

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Hsu, D.C., Ananworanich, J. (2017). Immune Interventions to Eliminate the HIV Reservoir. In: Silvestri, G., Lichterfeld, M. (eds) HIV-1 Latency. Current Topics in Microbiology and Immunology, vol 417. Springer, Cham. https://doi.org/10.1007/82_2017_70

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