The pursuit of an effective HIV cure is crucial, as the virus’s ability to hide in latent reservoirs, particularly within CD4+ T-cells, evades detection and ART; promising strategies like HIV-virus-like particles, “induce and reduce” approaches, and gene editing offer new hope for eradication.

Challenges in HIV Cure

The latent reservoirs where HIV hides present significant barriers to treatment and elimination efforts. These challenges highlight the need for more innovative approaches toward an effective HIV cure.

Promising Approaches

Virus-Like Particles (HLPs)

Researchers have developed HIV-virus-like particles (HLPs) that are 100 times more effective than other candidate HIV cure therapeutics. HLPs can specifically target and purge latent HIV reservoirs without infecting patients. This approach is affordable, can be administered via intramuscular injection, and has shown promising results across diverse HIV subtypes.

Induce and Reduce Strategy

ViiV Healthcare is advancing an “induce and reduce” strategy, which aims to flush out dormant HIV and subsequently eliminate it. This method utilises agents in combination with suppressive ART to safeguard healthy cells while focusing on the latent reservoirs.

TACK Drugs

TACK (Targeted Activation of Cell Kill) drugs, part of the NNRTI family, have demonstrated the ability to induce self-destruction in HIV-infected cells. These potent antivirals could play a role in contributing to an HIV cure by reducing the viral reservoir. Nonetheless, further confirmation of their safety and efficacy in humans is necessary.

Stem Cell Transplants

Reports of HIV remission following stem cell transplants from donors with the CCR5-delta 32 mutation, which confers genetic resistance to HIV, highlight the potential for this method. The latest case involves a patient with a single CCR5-delta 32 mutation, suggesting the possibility of broader applicability for this treatment.

Gene Editing

Innovations in gene editing technologies, such as CRISPR, are being examined to alter cells, rendering them resistant to HIV infection. Although initial trials have showcased safety and slight delays in viral rebound, extensive research is essential to achieve a permanent HIV cure.

Future Directions

– Ongoing research involves testing HLPs on larger cohorts, especially those with subtype C infections, to assess global applicability.
– Additional studies are required to verify the safety and efficacy of TACK drugs and other “induce and reduce” agents in people living with HIV.
– Continued investigation of gene editing and stem cell transplant techniques is vital, focusing on enhancing the safety and accessibility of these approaches.

Global Efforts and Goals

Global organisations such as the World Health Organization (WHO), the Global Fund, and UNAIDS are determined to end the HIV and AIDS epidemic by 2030. Achieving an effective HIV cure will necessitate sustained innovation, collaboration, and support for various cure strategies.