This year marks the 30th anniversary of the landmark discovery of human immunodeficiency virus (HIV) as the cause of acquired immunodeficiency syndrome (AIDS). BioMed Central brings together a collection of reviews and comments from across three of its journals – Retrovirology, BMC Medicine and BMC Biology – to discuss the tremendous progress made in understanding and combating the virus. The challenges remaining in understanding the fundamental science and clinical management of HIV are also considered, as despite the substantial success of antiretroviral therapies, neither a complete cure nor a protective vaccine against HIV has yet been found.
The collection was initiated by Kuan-Teh Jeang (Teh), Founding Editor-in-Chief of Retrovirology, who sadly passed away earlier this year. Teh leaves behind a great legacy to the retroviral research community not only through his research, with discoveries into the mechanism of HIV transcription and replication, but also through his leadership of Retrovirology and his determination to advance retroviral research.
The ‘HIV thirty years on’ collection includes two articles published in BMC Biology from authors noted for their significant contributions to HIV research. Robin Weiss, whose 1984 Nature paper showed that the cell surface CD4 molecule on T cells acts as a receptor for HIV, gives his perspective on progress made in the last 30 years, focusing on the gymnastics of HIV entry into cells, and how this can be blocked by antibodies or drugs. Andrew McMichael describes in an interview how he was drawn into work on HIV in the 1980s and has been pursuing a T cell vaccine ever since. McMichael explains why there is still hope that with the right vaccine design it will be possible to induce T cell responses capable of suppressing the virus much more effectively than those acquired during natural infection.
Several reviews from Retrovirology provide in depth looks at advances in various aspects of retroviral research. Natasja de Groot and Ronald Bontrop consider the evidence for past epidemics of HIV-1/SIV like retroviruses in chimpanzee populations, and their potential relevance to today’s HIV pandemic. The interaction between host cells and HIV is key to understanding the infection mechanisms of the virus and how to overcome them. Eveline Santos da Silva and colleagues focus on the viral envelope cytoplasmic tail; looking at its structure, function and interaction with host cellular components. Viral cells are notorious for being able to exploit host cells for their own ends and HIV is no exception. Marie Larsson and colleagues look at T cell inhibition during HIV infection, while Carine Van Lint and colleagues review HIV latency in human cells and potential therapeutics to target this stage of infection.
Therapeutics are also tackled: Ravindra Gupta, David Van de Vijver and colleagues discuss the drugs that are waiting in the wings to help alleviate the HIV burden. In a review by Torben Schiffner, Quentin Sattentau, and Lucy Dorrell the considerable impetus given to vaccine research by the finding that a few broadly neutralizing antibodies do arise during natural infection with HIV is highlighted. Schiffner and colleagues explain how this has re-ignited efforts to develop a prophylactic vaccine, with a number of promising and innovative approaches being used.
With the development of antiretroviral therapy, patients infected with HIV are living longer, with much improved quality of life, and BMC Medicine‘s contributions to the collection address how the advances in understanding HIV are being translated into daily clinical practice. A significant but unswered question is when to start therapy: Ricardo Franco and Michael Saag argue for starting therapy as soon as possible to reduce viral loads and prevent transmission, while Jens Lundgren and colleagues recommend a more cautious approach, recommending that therapy should be deferred until immunodeficiency develops to avoid unnecessary side effects.
In addition to appropriate timing of therapy, early diagnosis of HIV and its comorbidities is essential for effective treatment. In a video Q&A, Stephen Lawn discusses a new diagnostic test for HIV-associated tuberculosis (TB), and describes how it could save lives in resource-limited settings by improving rapid detection.
More of the latest research into HIV will be addressed at this year’s Frontiers in Retrovirology conference, run in conjunction with Retrovirology and marking the tenth anniversary of the journal.
The complete list of series articles: