HIV-1 Cell-to-Cell Transmission and Antiviral Strategies: An Overview

HIV-1 replicates by infecting new target cells either as cell-free viral particle or, much more efficiently, via cell-to-cell viral transmission. Cell-mediated viral spread, in which the infected cell directly transfers the viral particles to target cells via cell-cell contacts, in vitro is up to three orders of magnitude more efficient than transmission mediated by cell-free viral particles. Because of its potency, it has been suggested that current antiretroviral treatments could be less effective in blocking cell-to-cell viral transmission than cell-free. In this review, I will present an overview of the drug-based antiretroviral approaches as well as how the recently identified class of anti-HIV-1 broadly neutralizing antibodies could become part of an effective anti-viral strategy. I will discuss how both treatment strategies can be guided by our consideration that cell-to-cell HIV-1 spread is a major route of viral spread also in vivo.