Viral proteins and cellular partners involved in the
early events in the emergence of HIV from latency to
active replication have been a focus of drug development,
because the problems associated with both
emergence of viral resistance and perturbation of cellular
metabolism as well as viral knockdown vastly increase
after the onset of active HIV replication. The Tat–TAR
interaction has received special attention due to its
central role in the HIV transcriptional transactivation,
but cellular cofactors such as NF-kB are also targets of
drug development.4 Not surprisingly, drugs against
cellular cofactors have high toxicity, but are still being
pursued as options in the event of failure of HAART
chemotherapy. Other recently identified cofactors in
activation of HIV transcription include the Werner’s
syndrome helicase5 and p90 ribosomal S6 kinase 2
(RSK2).6
There has also been a great deal of interest regarding
the TAR-binding protein (TRBP) and its effects on HIV
replication. TRBP was initially identified as an activator
of HIV transcription, its subsequent recognition as a
partner of Dicer7 led to the suggestion that TAR subverts
the RNA interference (RNAi) pathway during HIV
infection by sequestering TRBP,8 which would be
expected to lead to a global decrease in endogenous
microRNA levels. However, HIV infection results in both
up- and downregulation of specific cellular microRNAs.9
siRNA-mediated knockdown of TRBP decreases expression
of RT and HIV total protein levels in HeLa cells
transfected with pNL4-3 proviral DNA while actin levels
are unaffected, suggesting that TRBP acts predominantly
to activate HIV replication.10 This is consistent with
observations that low endogenous expression of TRBP is
directly linked to low HIV replication in astrocytes, and
increasing expression of TRBP in astrocytoma cells
increases viral replication to the same level as observed
in HeLa cells.11,12 TRBP is thought to increase HIV
replication through its known effect as an antagonist to
PKR (RNA-binding protein kinase), inhibiting PKR
activation of the cellular immune response.
Additional cellular factors involved in HIV replication
continue to be identified. These include 11 cellular
microRNAs that are upregulated and downregulated9