Different Insights From Different Perspectives
Overview of HIV Medicines
Human immunodeficiency virus (HIV) targets the immune system by destroying CD4 cells, a type of white blood cell essential for combating infections. The depletion of these cells weakens the body’s defense mechanisms, making it susceptible to opportunistic infections and certain cancers. Without appropriate treatment, HIV can progress to acquired immunodeficiency syndrome (AIDS), the most severe phase of HIV infection. However, not all individuals with HIV will develop AIDS.
Antiretroviral Therapy (ART)
The primary treatment for HIV is antiretroviral therapy (ART), which involves the daily intake of a combination of HIV medicines. ART is recommended for all individuals diagnosed with HIV, irrespective of the duration since infection. While ART does not cure HIV, it significantly reduces the viral load—the amount of HIV in the body—thereby allowing individuals to live longer, healthier lives and diminishing the risk of transmitting the virus to others.
Mechanism of HIV Medicines
HIV medicines function by reducing the viral load, which aids the immune system in recovering and effectively combating infections and certain HIV-related cancers. Additionally, a lowered viral load decreases the likelihood of HIV transmission.
Classes of HIV Medicines
HIV medicines are categorized based on their mechanism of action:
- Nucleoside Reverse Transcriptase Inhibitors (NRTIs): These drugs inhibit the reverse transcriptase enzyme, preventing HIV from replicating its genetic material.
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): NNRTIs bind to and alter the reverse transcriptase enzyme, hindering HIV replication.
- Integrase Strand Transfer Inhibitors (INSTIs): These inhibitors block the integrase enzyme, which HIV uses to integrate its genetic material into the host cell’s DNA.
- Protease Inhibitors (PIs): PIs obstruct the protease enzyme, essential for the maturation of new HIV particles.
- Fusion Inhibitors: These prevent HIV from entering CD4 cells by blocking the fusion process.
- CCR5 Antagonists and Post-Attachment Inhibitors: These drugs block specific molecules on CD4 cells, preventing HIV from entering the cells.
- Attachment Inhibitors: They bind to a specific protein on the outer surface of HIV, preventing the virus from entering the cell.
Additionally, pharmacokinetic enhancers are used to boost the effectiveness of certain HIV medicines by slowing their breakdown, allowing them to remain in the body longer at higher concentrations. Multidrug combinations, which include two or more different types of HIV medicines, are also available to simplify treatment regimens.
Initiation of HIV Treatment
Prompt initiation of ART is crucial upon HIV diagnosis. Immediate treatment is especially important for individuals who are pregnant, have AIDS, have certain HIV-related illnesses and infections, or have an early HIV infection (within the first six months after infection).
Considerations for HIV Treatment
Developing a personalized treatment plan in collaboration with a healthcare provider is essential. Adherence to the prescribed medication regimen is vital for the effectiveness of ART. Regular monitoring through follow-up appointments ensures the treatment’s efficacy and allows for timely adjustments if necessary.
References
- HIV Medicines. National Library of Medicine.
- Wikipedia contributors. Bictegravir/emtricitabine/tenofovir alafenamide. Wikipedia, The Free Encyclopedia.
- Wikipedia contributors. Efavirenz/lamivudine/tenofovir. Wikipedia, The Free Encyclopedia.
Antiretroviral Therapy (ART)
ART involves the combination of at least three antiretroviral (ARV) drugs from at least two different classes to effectively suppress HIV replication. The eight classes of ARVs include nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), integrase strand transfer inhibitors (INSTIs), fusion inhibitors, CCR5 antagonists, CD4 post-attachment inhibitors, and gp120 attachment inhibitors. The standard initial treatment typically consists of two NRTIs combined with a third ARV from another class, such as an INSTI, NNRTI, or boosted PI. en.wikipedia.org
Treatment Initiation and Monitoring
The World Health Organization (WHO) and the United States recommend initiating ART in all individuals diagnosed with HIV, regardless of CD4 count, to improve health outcomes and reduce transmission. Once started, ART should be continued without interruption. The goal of ART is to achieve and maintain a plasma HIV-RNA count below 50 copies/mL. Viral load should be monitored initially after four weeks of treatment and every three to six months once suppression is achieved. en.wikipedia.org
Benefits of ART
Effective ART reduces the risk of HIV progression to AIDS and decreases mortality rates. It also improves physical and mental health, lowers the risk of opportunistic infections like tuberculosis, and reduces the likelihood of HIV transmission to sexual partners and from mother to child during pregnancy, childbirth, or breastfeeding. en.wikipedia.org
Adherence to ART
Adherence to ART is crucial for its effectiveness. Factors affecting adherence include access to medical care, social support, mental health status, substance abuse, complexity of treatment regimens, and adverse effects. High adherence rates have been observed in both high-income and low-income countries, with community-based approaches and the availability of generic drugs playing significant roles in improving adherence. en.wikipedia.org
Adverse Effects of ART
Common adverse effects of ART include lipodystrophy syndrome, dyslipidemia, diabetes mellitus (especially with PIs), diarrhea, and an increased risk of cardiovascular disease. Newer ART regimens are associated with fewer adverse effects, improving patient adherence and quality of life. en.wikipedia.org
Recent Developments in ART
The European Medicines Agency (EMA) has recommended the approval of long-acting injectable formulations of ARVs, such as rilpivirine (Rekambys) and cabotegravir (Vocabria), administered monthly or every two months. These formulations offer an alternative to daily oral pills, potentially improving adherence and quality of life for people living with HIV. en.wikipedia.org
Pediatric HIV Treatment
For children with HIV, treatment recommendations differ from adults. The WHO recommends treating all children under five years of age, while U.S. guidelines advise treatment for all children under 12 months and those with high viral loads between one and five years. Recent advancements include the development of a ‘4-in-1’ fixed-dose combination for pediatric HIV, combining lopinavir, ritonavir, lamivudine, and abacavir. This formulation is heat-stable, taste-masked, and suitable for infants and young children, improving treatment adherence and outcomes. en.wikipedia.org
References
- World Health Organization. Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach.
- Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services.
- European Medicines Agency. First long-acting injectable antiretroviral therapy for HIV recommended for approval.
- Drugs for Neglected Diseases Initiative. 4-in-1 (ABC/3TC/LPV/r).
- World Health Organization. Global action plan on HIV drug resistance 2017-2021.
- UNAIDS Data 2020.
Treatment for HIV
Antiretroviral medications are employed to manage HIV by inhibiting viral replication, thereby allowing the immune system to recuperate and preventing further damage. These medications are typically administered as daily oral tablets. Due to HIV’s propensity to develop resistance to single medications, a combination therapy approach is adopted to mitigate this risk. With early diagnosis and effective treatment, most individuals with HIV can lead a near-normal lifespan without developing AIDS-related illnesses.
References
- HIV and AIDS. Available at: https://www.nhs.uk/conditions/hiv-and-aids/
Long-acting therapies have revolutionized HIV treatment, transitioning from daily regimens to more manageable dosing schedules. Dr. Kimberly Smith, Head of Research and Development at ViiV Healthcare, highlights the transformative impact of these therapies on individuals like Beth, who, despite initial challenges with adherence, now thrives due to access to long-acting options.
Historically, HIV treatments in the 1980s required multiple daily pills, often accompanied by significant side effects and adherence difficulties. Advancements have since reduced the pill burden, with some regimens now requiring just a single daily pill. However, stigma, fear of status disclosure, and discrimination continue to pose challenges.
The development of long-acting therapies addresses these concerns by offering extended dosing intervals, thereby enhancing the quality of life for those living with HIV. ViiV Healthcare, building on GSK’s legacy of pioneering antiretroviral medicines, has been instrumental in this progress. Their focus includes extending dosing durations, achieving prolonged viral suppression, and exploring self-administration methods to empower patients.
Concurrently, efforts are underway to introduce new preventive HIV drugs to underserved regions. Gilead Sciences’ lenacapavir, a long-acting injectable, is anticipated to be available in low and middle-income countries by late 2025 or early 2026, pending regulatory approvals. Collaborations with organizations like the Global Fund aim to ensure affordable access to such innovations.
References:
Treatment Options
While there is currently no cure for HIV, it can be controlled with proper medical care. Antiretroviral therapy (ART) involves taking a combination of HIV medicines every day. ART helps reduce the viral load, maintain immune function, and prevent transmission. People with HIV who adhere to ART can live long and healthy lives.
Treatment of HIV/AIDS
While there is no cure for HIV/AIDS, effective treatment can control the virus and enable individuals to lead healthy lives. The primary treatment is antiretroviral therapy (ART), which involves a combination of HIV medicines taken daily. ART reduces the viral load, maintains immune system function, and reduces the risk of transmission.
Adherence to ART is crucial for its effectiveness. Regular monitoring by healthcare providers ensures the treatment is working and helps manage any side effects. Early initiation of ART is recommended for all individuals diagnosed with HIV, regardless of their CD4 T cell count, to reduce the risk of disease progression and transmission.
Clinical Trials and Research
Ongoing research is vital in the fight against HIV/AIDS. Clinical trials offer opportunities for patients to access new treatments and contribute to medical advancements. Participation in clinical trials is voluntary and can provide additional options for those seeking alternative therapies.
Supportive Care
Managing HIV/AIDS extends beyond medical treatment. Supportive care includes mental health services, nutritional support, and assistance with medication adherence. Comprehensive care improves the quality of life for individuals living with HIV/AIDS.
References
- Mayo Clinic Staff. (2023). HIV/AIDS: Diagnosis and treatment. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/hiv-aids/diagnosis-treatment/drc-20373531
Note: The information provided above is based on the Mayo Clinic’s guidelines on HIV/AIDS diagnosis and treatment. For personalized medical advice, please consult a healthcare professional.
This summary incorporates key information from the Mayo Clinic’s article on HIV/AIDS diagnosis and treatment, ensuring proper citation and ethical use of the source material.
GSK’s Commitment to HIV Treatment and Prevention
GlaxoSmithKline (GSK) has been at the forefront of HIV research and treatment, primarily through its majority-owned subsidiary, ViiV Healthcare. Established in 2009 as a joint venture between GSK and Pfizer, with Shionogi joining later, ViiV Healthcare specializes in developing therapies for HIV infection. As of December 2023, GSK holds a 76.5% stake in ViiV Healthcare, with Pfizer and Shionogi owning 13.5% and 10%, respectively.
Product Portfolio
ViiV Healthcare offers a comprehensive range of antiretroviral medications, including:
- Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Abacavir (Ziagen), Lamivudine (Epivir, 3TC), and Zidovudine (Retrovir, AZT).
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Delavirdine (Rescriptor).
- Attachment Inhibitors: Fostemsavir (Rukobia).
- Integrase Strand Transfer Inhibitors (INSTIs): Dolutegravir (Tivicay) and Cabotegravir (Apretude for PrEP; Vocabria/Cabenuva for HIV treatment, in partnership with Janssen Pharmaceuticals).
- Protease Inhibitors: Fosamprenavir (Lexiva, Telzir) and Nelfinavir (Viracept).
- Entry Inhibitors: Maraviroc (Selzentry, Celsentri).
- Fixed-Dose Combinations: Abacavir/Lamivudine (Epzicom, Kivexa), Abacavir/Lamivudine/Zidovudine (Trizivir), Lamivudine/Zidovudine (Combivir), Abacavir/Dolutegravir/Lamivudine (Triumeq), Dolutegravir/Lamivudine (Dovato), and Dolutegravir/Rilpivirine (Juluca, in partnership with Janssen Pharmaceuticals).
Global Reach and Access Initiatives
ViiV Healthcare operates globally, with headquarters in London and presence in countries including the United States, Australia, Belgium, Canada, France, Germany, Italy, Japan, Mexico, the Netherlands, Portugal, Puerto Rico, Russia, Spain, and Switzerland. The company is committed to improving access to HIV treatments by offering not-for-profit pricing in low- and middle-income countries and Sub-Saharan Africa. Additionally, ViiV has granted voluntary licenses to 14 generic manufacturers to produce affordable versions of its medications in specific regions.
Recent Developments
Despite challenges in other sectors, GSK’s HIV and oncology treatments have shown robust growth. In a recent financial report, the company noted that strong performances in these areas helped offset declines in vaccine sales.
References
- ViiV Healthcare. (2023). ViiV Healthcare. Retrieved from https://en.wikipedia.org/wiki/ViiV_Healthcare
- Jacks, A. (2024). GSK offsets vaccine losses with new drugs for cancer and HIV. The Times. Retrieved from https://www.thetimes.co.uk/article/gsk-vaccine-shingles-zantac-products-cancer-hiv-mhmbsvqb5
Note: The information provided above is based on available sources as of March 2025. For the most current information, please consult GSK’s official website or contact the company directly.
This summary highlights GSK’s significant contributions to HIV treatment and prevention through ViiV Healthcare, reflecting the company’s ongoing commitment to addressing the global HIV epidemic.
The National Health Service (NHS) in the United Kingdom provides comprehensive guidelines on the treatment of HIV and AIDS. While there is currently no cure for HIV, effective treatments enable most individuals with the virus to live long and healthy lives.
Emergency HIV Drugs: Post-Exposure Prophylaxis (PEP)
If you believe you’ve been exposed to HIV, post-exposure prophylaxis (PEP) may prevent infection. PEP must be initiated within 72 hours of exposure to be effective and involves taking HIV treatment daily for one month. It’s typically recommended following high-risk exposure, especially when the sexual partner is known to be HIV-positive. PEP can be accessed through sexual health clinics, genitourinary medicine (GUM) clinics, or hospital accident and emergency (A&E) departments.
Diagnosis and Monitoring
Upon an HIV diagnosis, regular blood tests are conducted to monitor the infection’s progression before starting treatment. Two critical tests are:
- HIV Viral Load Test: Measures the amount of HIV virus in the blood.
- CD4 Lymphocyte Cell Count: Assesses how HIV has affected the immune system.
Treatment initiation is personalized and determined in consultation with an HIV specialist.
Antiretroviral Drugs
HIV is managed with antiretroviral medicines that prevent the virus from replicating, allowing the immune system to repair itself and avert further damage. A combination of HIV drugs is used to reduce the risk of the virus developing resistance. Some treatments are available as fixed-dose combinations, combining multiple medications into a single pill, though these may be more costly. Most newly diagnosed individuals take between one and four pills daily. The effectiveness of treatment is monitored by measuring the viral load; achieving an undetectable viral load typically occurs within six months of consistent treatment. It’s important to note that many HIV medications can interact with other prescribed or over-the-counter medicines, including certain nasal sprays, inhalers, herbal remedies like St John’s wort, and some recreational drugs. Always consult with healthcare providers before taking additional medications.
For more detailed information, visit the NHS page on HIV and AIDS treatment.
Advancements in HIV Treatment: The Potential of Lenacapavir
Recent developments in HIV treatment have introduced innovative long-acting antiretroviral therapies, notably lenacapavir, which offer promising avenues toward ending the AIDS pandemic. Lenacapavir, developed by Gilead Sciences, is a capsid inhibitor that has demonstrated remarkable efficacy in both treatment and prevention of HIV infections.
Mechanism and Efficacy
Lenacapavir functions by binding directly to the HIV-1 capsid protein, disrupting essential steps in the viral replication cycle. Clinical studies have shown that lenacapavir, administered biannually, achieves 100% efficacy in preventing HIV infections among women and near-complete efficacy in men.
This long-acting injectable reduces the burden of daily medication adherence, offering a significant advancement in HIV prevention strategies.
Regulatory Approvals and Global Access
The U.S. Food and Drug Administration (FDA) granted priority review to lenacapavir, with a target action date set for June 2025.
Gilead Sciences has committed to making lenacapavir accessible in 120 low- and middle-income countries, particularly in regions with high HIV prevalence, such as Africa, Southeast Asia, and the Caribbean.
However, concerns remain regarding the exclusion of certain regions, like Latin America, from these initiatives, despite rising HIV rates in these areas.
Economic Considerations
In high-income countries, the annual cost of lenacapavir is approximately $40,000 per person. Studies suggest that mass production of a generic version could reduce the cost to around $40 per treatment, potentially increasing accessibility in resource-limited settings.
Advocates are urging governments to consider compulsory licensing to bypass patents in urgent public health scenarios, aiming to broaden access to this groundbreaking medication.
Challenges and Future Directions
Despite its potential, the rollout of lenacapavir faces challenges, including funding constraints and logistical hurdles. Recent U.S. foreign aid funding cuts have jeopardized plans by organizations like PEPFAR and The Global Fund to purchase and distribute lenacapavir in high-incidence regions, potentially hindering global efforts to control the HIV epidemic.
Addressing these challenges requires sustained global collaboration among pharmaceutical companies, governments, and civil society to ensure equitable access to this life-saving treatment.
Conclusion
Lenacapavir represents a significant advancement in HIV treatment and prevention, with the potential to transform the global AIDS response. Achieving widespread access to this innovative therapy necessitates concerted efforts to overcome economic and logistical barriers, ensuring that all individuals at risk of HIV infection can benefit from this medical breakthrough.
References
As of March 2025, significant advancements have been made in the pursuit of an HIV cure, with various research avenues showing promise:
CRISPR Gene Editing
CRISPR-Cas9 technology has emerged as a potential tool for eradicating HIV from the human genome. In 2021, studies demonstrated that combining antiretroviral therapy with CRISPR-Cas9 successfully eliminated HIV in 9 out of 23 humanized mice. Building on these findings, clinical trials in humans commenced in 2022. By October 2023, early-stage studies involving three participants indicated that the treatment was safe, though efficacy data were pending.
Stem Cell Transplants
Stem cell transplantation has led to functional cures in a limited number of cases. Notably, as of 2024, seven individuals have been reported cured of HIV following stem cell transplants from donors with specific genetic mutations conferring resistance to the virus. These cases include the “Berlin” (2008), “London” (2020), “Düsseldorf” (2022), “New York” (2022), and “City of Hope” (2023) patients. Additionally, the “Geneva” patient (2023) achieved remission without the donor mutation, remaining virus-free for 20 months post-transplant.
Biotechnology Initiatives
Companies like Excision BioTherapeutics are at the forefront of developing gene therapies targeting HIV. Their CRISPR-Cas9-based therapy, EBT-101, received Fast Track designation from the U.S. Food and Drug Administration in July 2023. By October 2023, early-stage studies involving three individuals reported no major side effects, though efficacy results were not yet disclosed.
These developments underscore a concerted global effort toward finding a definitive cure for HIV, with gene editing and stem cell therapies leading the charge.
In July 2024, during the 25th International AIDS Conference (AIDS 2024) in Munich, Germany, researchers introduced the “next Berlin Patient,” marking the world’s seventh documented case of an HIV cure following a stem cell transplant. This case is particularly noteworthy because, unlike previous instances where donors possessed a double CCR5-delta32 mutation—a genetic trait conferring resistance to HIV—the donor in this case had only a single copy of the mutation. This development broadens the potential for future HIV cure strategies, as it suggests a wider pool of compatible stem cell donors.
The CCR5-delta32 mutation affects the CCR5 receptor on the surface of immune cells, which many HIV strains utilize to enter these cells. Individuals with two copies of this mutation are highly resistant to HIV infection. The success of a stem cell transplant from a donor with a single CCR5-delta32 mutation indicates that even partial genetic resistance can contribute to eradicating the virus in the recipient.
This advancement underscores the evolving landscape of HIV cure research and offers hope for more accessible and varied treatment options in the future.
As of March 2025, significant advancements have been made in the pursuit of an HIV cure, with various research avenues showing promise:
CRISPR Gene Editing
CRISPR-Cas9 technology has emerged as a potential tool for eradicating HIV from the human genome. In 2021, studies demonstrated that combining antiretroviral therapy with CRISPR-Cas9 successfully eliminated HIV in 9 out of 23 humanized mice. Building on these findings, clinical trials in humans commenced in 2022. By October 2023, early-stage studies involving three participants indicated that the treatment was safe, though efficacy data were pending.
Stem Cell Transplants
Stem cell transplantation has led to functional cures in a limited number of cases. Notably, as of 2024, seven individuals have been reported cured of HIV following stem cell transplants from donors with specific genetic mutations conferring resistance to the virus. These cases include the “Berlin” (2008), “London” (2020), “Düsseldorf” (2022), “New York” (2022), and “City of Hope” (2023) patients. Additionally, the “Geneva” patient (2023) achieved remission without the donor mutation, remaining virus-free for 20 months post-transplant.
Biotechnology Initiatives
Companies like Excision BioTherapeutics are at the forefront of developing gene therapies targeting HIV. Their CRISPR-Cas9-based therapy, EBT-101, received Fast Track designation from the U.S. Food and Drug Administration in July 2023. By October 2023, early-stage studies involving three individuals reported no major side effects, though efficacy results were not yet disclosed.
These developments underscore a concerted global effort toward finding a definitive cure for HIV, with gene editing and stem cell therapies leading the charge.
In August 2011, Jörg Hoffman, head of the Diagnostics Department at the Institute of Medical Virology at Charité University Medicine in Berlin, delivered a lecture at the Oswaldo Cruz Institute (IOC/Fiocruz) discussing a pioneering case of HIV treatment. Hoffman detailed how a 40-year-old patient, who had been living with HIV since 1996 and undergoing antiretroviral therapy since 2002, also developed leukemia. The treatment involved a bone marrow transplant from a donor with a genetic mutation conferring resistance to HIV. Post-transplant, the patient exhibited no viral replication, and there was a notable increase in CD4+ T cells, indicating a positive immune response.
This case was significant as it demonstrated the potential for HIV eradication through targeted medical interventions. However, due to the complexity and risks associated with such procedures, they are not yet suitable for routine treatment. Nonetheless, this breakthrough has paved the way for further research into potential HIV cures, offering hope for more accessible treatment options in the future.
The video titled “HIV in 2025: What’s New, What’s Next?” provides an in-depth analysis of the latest advancements and future directions in HIV research and treatment as of 2025. It covers topics such as innovative therapies, preventive measures, and global strategies aimed at combating the HIV epidemic. The presentation also addresses the challenges and opportunities that lie ahead in the quest to end HIV transmission and improve the quality of life for those living with the virus.
In February 2023, an international team of researchers reported the successful cure of HIV in a patient known as the “Düsseldorf patient.” This individual, diagnosed with HIV, underwent a hematopoietic stem cell transplantation to treat a severe blood cancer. The donor’s stem cells carried a mutation in the CCR5 gene, rendering most HIV strains unable to enter target immune cells. Over a span of nearly ten years, extensive virological and immunological analyses revealed no detectable HIV replication. Antiretroviral therapy was discontinued more than four years prior to the report, with no signs of viral rebound, leading researchers to declare the patient cured.
This case underscores the potential of stem cell transplantation with CCR5 mutation as a curative approach for HIV, though its applicability is limited to specific scenarios due to the procedure’s complexity and associated risks.
HIV presents unique challenges to eradication due to its ability to integrate into the host’s genome and establish latent reservoirs:
- Integration into Host DNA: HIV inserts its genetic material into the DNA of host cells, particularly long-lived central memory T-cells. This integration allows the virus to remain hidden from the immune system and antiretroviral therapies (ART).
- Latent Reservoirs: The virus establishes reservoirs in these memory T-cells, which can persist for extended periods. If ART is interrupted, these reservoirs can reactivate, leading to renewed viral replication.
These factors necessitate continuous ART to suppress the virus, as current treatments cannot eliminate these hidden reservoirs.
In March 2024, researchers from the University of Bristol and international collaborators reported a significant advancement toward an HIV cure. They developed a therapeutic candidate known as the HIV-like particle (HLP), which effectively targets and eliminates latent HIV reservoirs. HLPs are non-infectious particles that present a comprehensive set of HIV proteins, enhancing immune responses without causing infection. In studies using blood samples from individuals with chronic HIV, HLP demonstrated a potency 100 times greater than other therapeutic candidates. Notably, HLP can be administered via intramuscular injection, similar to seasonal flu vaccines, offering a potentially accessible and affordable treatment option.
This breakthrough represents a critical step toward achieving the World Health Organization’s goal of ending the HIV/AIDS epidemic by 2030. By effectively purging latent HIV reservoirs, HLP therapy could enable millions of individuals living with HIV to achieve a life free from the virus. Ongoing research and clinical trials will be essential to validate these findings and facilitate the widespread adoption of this promising treatment.
The pursuit of an HIV cure is akin to solving a complex puzzle, requiring a multifaceted approach to address various challenges. According to HIV i-Base, a UK-based HIV treatment activist charity, cure research focuses on several key areas:
- Activating Latent Viral Reservoirs: HIV can remain dormant in certain cells, evading detection and treatment. Researchers aim to “wake up” these latent cells to target and eliminate the hidden virus.
i-base.info - Investigating Ongoing HIV Replication: Understanding whether HIV continues to replicate in specific body compartments, even under antiretroviral therapy (ART), is crucial. This includes identifying anatomical sites where ART may not fully penetrate.
i-base.info - Reversing Immune System Damage: Chronic HIV infection can impair immune function. Research is exploring methods to repair and restore the immune system’s capacity to combat infections effectively.
i-base.info - Developing Immune-Based Therapies: Scientists are working on vaccines or immune-based treatments that enable the immune system to control HIV without the continuous need for ART.
i-base.info
he study titled “Safety and efficacy of vesatolimod (GS-9620) in combination with antiretroviral therapy in HIV-1-infected virologically suppressed adults: a phase 1b, randomised, double-blind, placebo-controlled trial,” published in The Lancet HIV in 2018, evaluated vesatolimod (GS-9620), a toll-like receptor 7 (TLR7) agonist, as a potential agent to target latent HIV reservoirs. The trial involved virologically suppressed adults on antiretroviral therapy (ART). Participants received vesatolimod or placebo to assess safety, tolerability, and immunomodulatory effects. The findings indicated that vesatolimod was generally well-tolerated and induced immune activation without causing significant adverse effects. However, the study did not observe a significant reduction in the size of the latent HIV reservoir or sustained virological control after treatment interruption. These results suggest that while vesatolimod can safely activate immune responses, additional strategies are necessary to achieve effective reduction of HIV reservoirs and viral remission.
Recent studies have highlighted lenacapavir, a novel HIV treatment administered biannually, as a significant advancement in HIV prevention and treatment. Clinical trials have demonstrated its high efficacy, with a large trial indicating that 99.9% of participants who received the injection did not acquire HIV, outperforming daily oral medications like Truvada.
Gilead Sciences, the developer of lenacapavir, plans to seek FDA approval by the end of 2024, aiming for a 2025 launch. The company has also announced plans to make lenacapavir available at reduced prices in 120 low- and middle-income countries, primarily in Africa, Southeast Asia, and the Caribbean, to enhance global accessibility.
While lenacapavir has shown 100% effectiveness in preventing HIV infections in women and near similar results in men, concerns remain about its accessibility in certain regions, particularly in Latin America, which are excluded from the current distribution plans despite rising HIV rates.
The introduction of lenacapavir marks a potential turning point in HIV prevention and treatment, offering a more convenient and effective alternative to daily medication regimens. However, ensuring equitable access to this groundbreaking therapy across all regions remains a critical challenge.
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