Shock and kill

Abstract

Antiretroviral therapies block HIV replication but they do not eliminate inactive viruses within cells. A clinical trial shows that a drug can revive HIV in patients as a potential first step towards a cure. See Letter p.482 A major barrier to achieving a cure in patients infected with HIV-1 is the ability of the HIV genome to integrate into the DNA of resting CD4+ T cells and adopt a state of latency, evading both immune detection and pharmaceutical attack. It was shown previously that induction of virus gene expression in latently HIV-1-infected cells can be achieved in vitro with histone deacetylase inhibitors such as vorinostat, a drug used to treat cutaneous lymphoma. In this study, the authors report the first in vivo evidence that vorinostat can disrupt proviral latency of HIV-1. Vorinostat has some toxic effects that would need to be considered when assessing the risks and benefits of attempts to eradicate HIV infection using this or similar drugs.