Immunologic strategies for HIV-1 remission and eradication

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Immunologic strategies for HIV-1 remission and eradication by Dan H. Barouch, and Steven G. Deeks Science Volume 345(6193):169-174 July 11, 2014 Copyright © 2014, American Association for the Advancement of Science

Fig. 1 “Shock and kill” strategies. “Shock and kill” strategies. Latent HIV-1 reservoirs in resting CD4+ T cells can be activated (“shocked”), which might make them more susceptible to be eliminated (“killed”) by immunologic effector mechanisms. Dan H. Barouch, and Steven G. Deeks Science 2014;345:169-174 Copyright © 2014, American Association for the Advancement of Science

Fig. 2 Immunotherapeutic strategies. Immunotherapeutic strategies. T cell proliferation and activation have complex effects on the size and distribution of the viral reservoir. Homeostatic cytokines and antigen-driven proliferation of T cells maintain a population of latently infected cells. Activation of T cells can either lead to virus production and virus spread (reservoir maintenance) or death of these cells because of virus-induced cytopathic effect or host clearance mechanisms (reservoir depletion). Therapies that alter the proliferation, maturation, activation, and effector functions of T cells could impact these processes. Immunotherapies, such as neutralizing antibodies and therapeutic vaccines, as well as immune modulating drugs, such as PD-1 inhibitors, sirolimus, type I interferon (IFN), and IL-7, may lead to reservoir depletion. Dan H. Barouch, and Steven G. Deeks Science 2014;345:169-174 Copyright © 2014, American Association for the Advancement of Science

Fig. 3 PrEP/PEP/cure continuum. PrEP/PEP/cure continuum. ART initiated before exposure is termed preexposure prophylaxis (PrEP), whereas ART initiated shortly after exposure is postexposure prophylaxis (PEP) and forms a continuum with efforts aimed at virus eradication (cure). Even if early ART is not curative, it may reduce the size of the viral reservoir and preserve immune function. Dan H. Barouch, and Steven G. Deeks Science 2014;345:169-174 Copyright © 2014, American Association for the Advancement of Science