Purpose of review: This review aims to identify which patient based observations could enable the development of new surrogate markers for widespread clinical use.
Recent findings: Anti-retroviral drug therapy reduces but does not abolish HIV transmission and replication in all body compartments. It is now clear that monitoring plasma HIV RNA does not help to predict drug failure or to define the existence of persistent viral reservoirs.
Summary: New surrogate markers are required for long-term patient monitoring and to enable the evaluation of additional therapeutic strategies.