Abstract
Even during effective treatment with antiretroviral drugs, low levels of HIV persist. In part, this could be due to cell-to-cell transfer of multiple virions and the drugs' inability to inhibit replication when virus levels are high. See Letter p.95 Antiretroviral therapy suppresses, but does not eradicate, HIV infection. Low-level viraemia continues for life because of the persistence of treatment-resistant reservoirs of the virus. Various different types of reservoir are thought to exist. David Baltimore and colleagues use a combination of mathematical modelling and a cell culture model of HIV infection and drug treatment to propose that ongoing HIV replication can occur in the presence of drugs if the cells become infected through cell-to-cell transmission. They propose that cell-to-cell spread of virus could be a source of localized and intermittent ongoing replication, which may show little evolution, and which could contribute to replenishment of the virus reservoir and virus persistence.
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