Emerging Research and Treatment
There is a lot of exciting and innovative research currently ongoing when it comes to HIV. Some efforts are focused on achieving HIV remission without the use of daily ART (antiretroviral therapy), while others are focused on eliminating all HIV from the body, even when it is inactively hiding within cells (also called being latent).1 The HIV research landscape is busy and exciting as we work toward finding improvements in HIV treatment and care.
HIV has the ability to become latent, meaning it can hide out within cells in our body. This is one of the properties of HIV that makes it difficult to completely cure. Although taking ART every day exactly as prescribed can reduce an individual’s viral load below detectable limits (called being “undetectable”), some HIV will always be in hiding.
For this reason, if an individual who was previously undetectable stops taking their medication, their HIV can become detectable and cause damage again. A current area of investigation focuses on creating longer-lasting medications that need to be taken less frequently but still have the same effect as daily therapy.1,2
HIV vaccines and immune system-boosting therapies
Scientists are currently investigating ways to ramp up the immune system in order to fight HIV, including developing virus-targeting proteins called antibodies or a potential HIV vaccine.
One area of study focuses on broadly neutralizing antibodies (bNAbs). These antibodies can help prevent HIV from infecting their target cells in the body, as well as help the body identify and kill cells that are currently infected. Many individuals have these proteins already, but they are not in high enough amounts to significantly impact the virus.
Some theories have suggested that infusions of these antibodies after an individual has stopped ART may help keep the virus in check without needing long-term medications. Much more research is needed on these and other potentially HIV-fighting antibodies in order to determine their effects.2
Vaccines that help the immune system make more bNAbs are also being investigated. In addition, vaccines that help strengthen the human T cell response to HIV are being researched. T cells are human cells that HIV infects; however, they are also powerful immune system regulators. Vaccines aimed at improving T cell response and function may help our bodies fight off HIV and/or prevent new HIV infections in those who are vaccinated. However, further investigation is needed.2
Treatments aimed at eliminating latent HIV
As mentioned, HIV can hide out in cells even when an individual’s viral load (the amount of virus in the blood) is undetectable. Our immune system may not recognize that a cell with latent HIV has the virus, and will allow it to continue living with the hidden virus inside.
There are current research efforts aimed at finding HIV that is hiding and eliminating it from the body. Some of these involve finding new treatments that can kick-start HIV to come out of hiding. When this happens, the immune system or other treatment options can target these newly activated cells, and decrease the amount of virus that is latent within the body.3
Stem cell transplants and gene therapy
Scientists are also currently looking into stem cell transplants and gene therapy in order to cure HIV. Some individuals possess a specific gene mutation that changes a protein on their cells’ surface called CCR5. CCR5 is used by HIV to enter its target cells and replicate. In individuals with a mutation that changes their CCR5, HIV may have a harder time getting into and infecting cells.
Scientists have been investigating the use of stem cell transplants or gene therapy to get this specific gene into individuals who don’t normally have it, potentially stopping HIV from infecting their cells. Other gene therapy efforts are aimed at eliminating latent HIV from infected cells’ DNA, as well as editing certain genes to make certain cells better HIV fighters.3