Antiretroviral Intensification and the HIV Latent Reservoir

Despite the ability of combination antiretroviral therapy (ART) to reduce HIV RNA to extremely low levels in the blood, the virus persists in long-lived reservoirs found in resting memory CD4 cells — the latent reservoir — and tissues. In recent years, various intensification trials — in which other agents have been added to standard ART regimens — have failed to demonstrate a reduction in plasma HIV RNA levels (measured using sensitive research assays). Now, researchers in Spain have examined the effect of antiretroviral intensification on HIV in resting CD4 cells.

Fifteen patients on standard ART with undetectable plasma HIV RNA (as measured by commercial assays) received maraviroc (n=7) or raltegravir (n=8) intensification for 48 weeks; t…