HIV-1 is a retrovirus capable of establishing viral reservoirs that remain stable for extended periods under suppressive antiretroviral therapy (ART). Immune dysfunction and latency are well known to contribute to this longevity, but the respective roles of viral replication and latently infected (LI) cell proliferation under suppressive antiretroviral therapy (ART) have long been controversial. This historical review critically appraises the body of evidence regarding possible viral replication and proliferation of infected cells under ART. An ever-growing body of genetic and phylogenetic studies has demonstrated that HIV-infected cells are able to proliferate and contribute to the longevity of the reservoir in ART-treated patients. The role of ongoing replication remains controversial: it has been well established that HIV does not undergo evolution during ART or develop drug resistance, but some genetic, phylogenetic, and in vivo imaging studies have suggested that there may be ongoing replication despite this. The respective roles of viral replication and cellular proliferation in maintaining the LI reservoir remains an area of controversy. Elucidating these processes may allow us design interventions to reduce the size of the LI reservoir, increasing the length of treatment interruptions during which the virus will remain adequately suppressed, bringing us closer to a functional cure. Novel experimental techniques such as immuno-PET and digital droplet PCR (ddPCR) are increasingly being employed, and these, along with rapid particle sorting techniques currently in develop-ment, will be necessary to fully answer this question.

中文翻译：

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HIV 如何在抗逆转录病毒治疗下持续存在：证据回顾。

HIV-1 是一种逆转录病毒，能够建立病毒库，在抑制性抗逆转录病毒疗法 (ART) 下可长时间保持稳定。众所周知，免疫功能障碍和潜伏期会导致这种长寿，但病毒复制和潜伏感染 (LI) 细胞增殖在抑制性抗逆转录病毒疗法 (ART) 下的各自作用长期以来一直存在争议。这篇历史回顾批判性地评估了关于在 ART 下可能的病毒复制和感染细胞增殖的证据。越来越多的遗传和系统发育研究表明，感染 HIV 的细胞能够增殖并有助于延长接受 ART 治疗的患者体内的蓄水池寿命。持续复制的作用仍然存在争议：众所周知，HIV 在 ART 期间不会发生进化或产生耐药性，但一些遗传、系统发育和体内成像研究表明，尽管如此，仍可能存在持续复制。病毒复制和细胞增殖在维持 LI 储库中的各自作用仍然是一个有争议的领域。阐明这些过程可能使我们能够设计干预措施以减少 LI 储库的大小，增加治疗中断的时间，在此期间病毒将保持充分抑制，使我们更接近功能性治愈。新的实验技术，如免疫 PET 和数字液滴 PCR (ddPCR) 越来越多地被采用，这些技术以及目前正在开发的快速颗粒分选技术将是充分回答这个问题所必需的。