Abstract:
INTRODUCTION : HIV eradication and remission research has largely taken place in high-income countries. In low- and middleincome
countries (LMIC), there may be factors that have a substantial impact on the size of the latent HIV reservoir and the
immunological response to infection. If a curative strategy is to be available to all HIV-infected individuals, these factors must
be understood.
METHODS : We use a scoping review to examine the literature on biological factors that may have an impact on HIV
persistence in LMIC. Three databases were searched without date restrictions.
RESULTS : Uncontrolled viral replication and higher coinfection prevalence may alter the immunological milieu of individuals in
LMIC and increase the size of the HIV reservoir. Differences in HIV subtype could also influence the measurement and size of
the HIV reservoir. Immune activation may differ due to late presentation to care, presence of chronic infections, increased
gut translocation of bacterial products and poor nutrition.
CONCLUSIONS : Research on HIV remission is urgently needed in LMIC. Research into chronic immune activation in resource
poor environments, the immune response to infection, the mechanisms of HIV persistence and latency in different viral
clades and the effect of the microbiological milieu must be performed. Geographic differences, which may be substantial and
may delay access to curative strategies, should be identified.
