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Reservoir measurement and tissue mapping

Cure research depends on measuring a rare, diverse and anatomically distributed reservoir. No single assay captures intactness, inducibility, integration site, clonality, transcription and rebound competence at once.

Publisher
The Bach Foundation
Audience
Public · Professional · Research
Last reviewed
18 August 2026
Status
Source-linked
Jurisdiction
Global context; local guidance may vary

Direction at a glance

Cure research depends on measuring a rare, diverse and anatomically distributed reservoir. No single assay captures intactness, inducibility, integration site, clonality, transcription and rebound competence at once.
Clinical researchDiagnosticsAssay standardization and multimodal profiling

What the evidence establishes

  • Most proviral DNA detected in treated people is defective.
  • Blood sampling incompletely represents reservoirs in lymphoid, gut and other tissues.
  • Assay differences can make cross-study comparisons unreliable.

Next decisive research questions

01Which combination of assays best predicts rebound?
02Can tissue sampling become less invasive?
03How should laboratories harmonize standards and reference materials?
04Can single-cell and spatial methods become scalable trial endpoints?

Limits and responsible interpretation

What this direction does not yet prove

A biomarker may correlate with one reservoir feature without predicting clinical control. Treatment interruption remains the definitive but risky test of remission.

Development pathway

How this direction should be evaluated
DecisionRequired evidence
Biological activityTarget engagement and an outcome that cannot be explained by assay noise or selection.
Clinical valueMeaningful benefit, adequate follow-up, safety, comparison with current standard care and transparent uncertainty.
GeneralizabilityDiverse populations, subtypes, geographies, ages and clinically relevant comorbidities.
ScalabilityManufacturing, delivery, monitoring, price, workforce and community acceptability.
Additional permanent evidence gateways