The drugs used to treat individuals infected with HIV-1 keep the virus under control and dramatically improve prognosis, but they do not eliminate the virus from the body completely, some remains hidden in immune cells known as resting CD4+ T cells. There are currently no clinically acceptable strategies for eliminating this reservoir of HIV-1. However, Robert Siliciano and colleagues, at Johns Hopkins University School of Medicine, Baltimore, have developed an in vitro system that mimics the situation in people and used it to identify a compound that can get at this hidden HIV-1 and eliminate it from the CD4+ T cells. Importantly, this compound does not cause global T cell activation, the side effect that has made other approaches to eliminating the HIV-1 reservoir clinically unacceptable. However, it has other potential toxicity issues that are likely to preclude its use in the clinic. The authors therefore hope to use their in vitro system to screen more compounds so that a clinically acceptable drug that eliminates HIV-1 can be developed.
