HIV proviral reservoir / autologous T cells

Class

Ex vivo gene-modified T-cell therapy

HIV establishes a persistent reservoir by integrating its genetic material, called a provirus, into the DNA of long-lived resting CD4 T cells, the immune cells the virus normally infects. Because these cells can remain quiescent for years, antiretroviral drugs, which block active viral replication, cannot eliminate the reservoir, and the virus rebounds if treatment stops. Ex vivo gene-modified T-cell therapy addresses this by removing a patient's own T cells, genetically altering them outside the body to resist infection or to better recognize and destroy infected cells, and then reinfusing them. This autologous approach avoids immune rejection since the cells originate from the same patient. The rationale is twofold: protect uninfected CD4 T cells from new infection, preserving immune function, while simultaneously strengthening the ability of the immune system to find and clear cells harboring latent virus. This strategy is relevant to the broader goal of achieving sustained viral control without continuous drug therapy, sometimes described as a functional cure, and is being explored primarily in chronic HIV infection where standard antiretroviral therapy suppresses circulating virus but cannot reach or eliminate the hidden proviral reservoir.