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Experimental Approaches for Eliminating Latent HIV.

Antiretroviral therapy (ART) can reduce HIV viral loads to undetectable levels and prevent disease progression. However, HIV persists in rare cellular reservoirs within ART-treated patients and rapidly reemerges if ART is stopped. Latently infected CD4+ T cells represent a major reservoir of HIV that persists during ART. Therefore, a cure for HIV must include methods that either permanently inactivate or eliminate latent virus. Experimental methods under investigation for eliminating latently infected cells include transplantation/gene therapy approaches intended to deplete the infected cells and replace them with HIV-resistant ones, and DNA editing strategies that are capable of damaging or excising non-expressing HIV proviruses. Alternatively, "activation-elimination," also known as "shock and kill," approaches aim to induce expression of latent virus, allowing the virus to be eliminated by viral cytopathic effects, immune effector mechanisms, or additional cells/antibodies that specifically target and kill cells expressing HIV proteins. Here, we describe these experimental approaches for eliminating latent HIV along with other recent advances in HIV cure research.