Escape Mutations: Another Challenge for HIV Eradication

The long-term persistence of latent HIV in patients on antiretroviral therapy (ART) is one of the main barriers to eradicating the virus. A strategy under consideration for clearing latent HIV is combining an agent to reverse latency with a vaccine to boost immune responses against reactivated virus, thereby leading to killing of infected cells. Now, investigators have found that immune-mediated clearance may be more challenging than previously thought.

The investigators sequenced proviral DNA from HIV-infected patients on ART and looked for escape mutations that confer resistance to cytotoxic T lymphocytes (CTLs), one of the main immune responses against the virus. In the 15 patients who initiated ART during chronic infection, almost all of…