The eradication of HIV-1 will likely require novel clinical approaches to purge the reservoir of latently infected cells from a patient. We hypothesize that this therapy should target a wide range of latent integration sites, act effectively against viral variants that have acquired mutations in their promoter regions, and function across multiple HIV-1 subtypes. By using primary CD4؉ and Jurkat cell-based in vitro HIV-1 latency models, we observe that single-agent latency reactivation therapy is ineffective against most HIV-1 subtypes. However, we demonstrate that the combination of two clinically promising drugs-namely, prostratin and suberoylanilide hydroxamic acid (SAHA)-overcomes the limitations of single-agent approaches and can act synergistically for many HIV-1 subtypes, including A, B, C, D, and F. Finally, by identifying the proviral integration position of latent Jurkat cell clones, we demonstrate that this drug combination does not significantly enhance the expression of endogenous genes nearest to the proviral integration site, indicating that its effects may be selective.HIV-1 postintegration latency poses the greatest barrier to complete eradication of the virus from a patient (25). Latent infections have low or no transcriptional activity and fail to generate viral progeny, rendering them untreatable with current antiretroviral treatments that target only actively replicating virus (78). Moreover, latent infections, which persist in resting memory CD4 ϩ T cells with a half-life of up to 44 months (79), provide a permanent reservoir for reactivation and reseeding of the replicating virus (83). Therapeutic reactivation of latent infections, combined with antiretroviral treatments, may accelerate the depletion of latent reservoirs (reviewed in reference 29). However, such latency reactivation strategies have yielded variable results in recent clinical trials (49,80,82), underscoring the difficulties associated with purging latent infections. Therefore, the complexities of latency warrant the further development of in vitro analytical and screening assays that can model the conditions of latency and test potential therapies (9).After viral entry and integration of the viral genome into the host chromosome, the HIV 5Ј long terminal repeat (5Ј LTR) promoter recruits RNA polymerase II (RNAPII) and other host factors to regulate viral gene expression. Initially, low basal transcription generates primarily abortive transcriptsdue to the stalling of RNAPII-and a small fraction of fully elongated viral transcript that is initially spliced to generate mRNA encoding a positive regulator, the transcriptional activator (Tat) (47). Tat protein interacts with cellular positive transcriptional elongation factor B (P-TEFb) (99), and the resulting Tat-P-TEFb complex binds to the trans-activation response (TAR) element at the 5Ј end of nascent viral transcripts (3). Here, P-TEFb phosphorylates the C-terminal domain (CTD) of stalled RNAPII to enhance the efficiency of elongation (98). This Tat-mediated transactivation...