FIG 4.

Steps from measuring the increase in CA HIV RNA under LRA treatment to estimating the reduction of the latent HIV reservoir. LRAs increase the rate of reactivation of HIV transcription in latently infected cells. By measuring the maximal fold increase in the quantity of CA HIV RNA in blood under LRA treatment and the rate of decay after LRA treatment is stopped, one can estimate the greatest possible increase in the HIV reactivation rate. HIV reactivation is only one of a number of mechanisms of loss and renewal that regulate the number of cells latently infected by HIV in patients on ART. Other factors involved in the maintenance of the latent reservoir can also significantly affect our estimates of reservoir reduction. The final reduction of the latent reservoir caused by increasing HIV reactivation can be estimated only when the relative contributions of these mechanisms are better understood.