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Joao Pauzinho

This might be a naive question, but an immunologist friend of mine observed that the entire field of HIV latency reversal presupposes that antiretroviral therapy is shutting down active viral replication 100%.

If there is, as appears to be, on-going low level viral replication on even the most successful suppressive combination therapies, is it accurate to say that the only remaining virus is latent? It would seem that a cure would need to have at least 3 components: 1) treatment intensification (a tat inhibitor or even perhaps something that recruits a more effective innate immune response, such as NK cells) to actually stop ALL active replication; 2) a way to excise or inactivate integrated virus (or to destroy or render permanently dormant virus-infected cells) and 3a) fix a defective immune response that could clean up the mess and effectively survey for any subsequent emergent trouble— and/or 3b) genetically engineer HIV-resistant immune cells and preemptively repopulate the body with such cells.

If this is a fair portrayal, it would seem the HDAC/LRA field of research might be receiving an undue amount of attention. Thank you for all your great work.

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