Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner?
Once a death sentence, HIV is now considered a manageable chronic disease due to the development of antiretroviral therapy (ART) regimens with minimal toxicity and a high barrier for genetic resistance. While highly effective in arresting AIDS progression and rendering the virus untransmissible in...
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| Format: | Članak |
| Jezik: | English |
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Case Western Reserve University
2024-03-01
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| Serija: | Pathogens and Immunity |
| Teme: | |
| Online pristup: | https://www.paijournal.com/index.php/paijournal/article/view/665 |
| _version_ | 1827333926762315776 |
|---|---|
| author | Justin Harper Michael Betts Mathias Lichterfeld Michaela Müller-Trutwin David Margolis Katharine Bar Jonathan Li Joseph McCune Sharon Lewin Deanna Kulpa Dázon Diallo Michael M. Lederman Mirko Paiardini |
| author_facet | Justin Harper Michael Betts Mathias Lichterfeld Michaela Müller-Trutwin David Margolis Katharine Bar Jonathan Li Joseph McCune Sharon Lewin Deanna Kulpa Dázon Diallo Michael M. Lederman Mirko Paiardini |
| author_sort | Justin Harper |
| collection | DOAJ |
| description |
Once a death sentence, HIV is now considered a manageable chronic disease due to the development of antiretroviral therapy (ART) regimens with minimal toxicity and a high barrier for genetic resistance. While highly effective in arresting AIDS progression and rendering the virus untransmissible in people living with HIV (PLWH) with undetectable viremia (U=U) [1, 2]), ART alone is incapable of eradicating the “reservoir” of resting, latently infected CD4+ T cells from which virus recrudesces upon treatment cessation. As of 2022 estimates, there are 39 million PLWH, of whom 86% are aware of their status and 76% are receiving ART [3]. As of 2017, ART-treated PLWH exhibit near normalized life expectancies without adjustment for socioeconomic differences [4]. Furthermore, there is a global deceleration in the rate of new infections [3] driven by expanded access to pre-exposure prophylaxis (PrEP), HIV testing in vulnerable populations, and by ART treatment [5]. Therefore, despite outstanding issues pertaining to cost and access in developing countries, there is strong enthusiasm that aggressive testing, treatment, and effective viral suppression may be able to halt the ongoing HIV epidemic (ie, UNAIDS’ 95-95-95 targets) [6–8]; especially as evidenced by recent encouraging observations in Sydney [9].
Despite these promising efforts to limit further viral transmission, for PLWH, a “cure” remains elusive; whether it be to completely eradicate the viral reservoir (ie, cure) or to induce long-term viral remission in the absence of ART (ie, control; Figure 1). In a previous salon hosted by Pathogens and Immunity in 2016 [10], some researchers were optimistic that a cure was a feasible, scalable goal, albeit with no clear consensus on the best route. So, how are these cure strategies panning out? In this commentary, 8 years later, we will provide a brief overview on recent advances and failures towards identifying determinants of viral persistence and developing a scalable cure for HIV. Based on these observations, and as in the earlier salon, we have asked several prominent HIV cure researchers for their perspectives.
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| first_indexed | 2024-03-07T17:38:39Z |
| format | Article |
| id | doaj.art-206655f9eb1544268da28d0832f4e784 |
| institution | Directory Open Access Journal |
| issn | 2469-2964 |
| language | English |
| last_indexed | 2024-03-07T17:38:39Z |
| publishDate | 2024-03-01 |
| publisher | Case Western Reserve University |
| record_format | Article |
| series | Pathogens and Immunity |
| spelling | doaj.art-206655f9eb1544268da28d0832f4e7842024-03-02T16:11:04ZengCase Western Reserve UniversityPathogens and Immunity2469-29642024-03-018210.20411/pai.v8i2.665Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner?Justin Harper0Michael Betts1Mathias Lichterfeld2Michaela Müller-Trutwin3David Margolis4Katharine Bar5Jonathan Li6Joseph McCune7Sharon Lewin8Deanna Kulpa9Dázon Diallo10Michael M. Lederman11Mirko Paiardini12Division of Microbiology and Immunology, Emory National Primate Research Center, Emory University, Atlanta, GeorgiaDepartment of Microbiology, Perelman School of Medicine, University of Pennsylvania; Center for AIDS Research, University of Pennsylvania, Philadelphia, PennsylvaniaRagon Institute of MGH, MIT and Harvard, Cambridge; Infectious Disease Division, Brigham and Women’s Hospital, Boston, MassachusettsHIV Inflammation and Persistence Unit, Institut Pasteur, Université Paris-Cité, Paris, FranceDivision of Infectious Diseases, Center for AIDS Research, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North CarolinaCenter for AIDS Research, University of Pennsylvania; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaBrigham and Women’s Hospital, Harvard Medical School, Boston, MassachusettsHIV Frontiers, Global Health Accelerator, Bill & Melinda Gates FoundationDepartment of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity; Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity; Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, AustraliaDivision of Microbiology and Immunology, Emory National Primate Research Center, Emory University; Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GeorgiaSisterLove, Inc., Atlanta, GeorgiaDivision of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, OhioDivision of Microbiology and Immunology, Emory National Primate Research Center, Emory University; Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia Once a death sentence, HIV is now considered a manageable chronic disease due to the development of antiretroviral therapy (ART) regimens with minimal toxicity and a high barrier for genetic resistance. While highly effective in arresting AIDS progression and rendering the virus untransmissible in people living with HIV (PLWH) with undetectable viremia (U=U) [1, 2]), ART alone is incapable of eradicating the “reservoir” of resting, latently infected CD4+ T cells from which virus recrudesces upon treatment cessation. As of 2022 estimates, there are 39 million PLWH, of whom 86% are aware of their status and 76% are receiving ART [3]. As of 2017, ART-treated PLWH exhibit near normalized life expectancies without adjustment for socioeconomic differences [4]. Furthermore, there is a global deceleration in the rate of new infections [3] driven by expanded access to pre-exposure prophylaxis (PrEP), HIV testing in vulnerable populations, and by ART treatment [5]. Therefore, despite outstanding issues pertaining to cost and access in developing countries, there is strong enthusiasm that aggressive testing, treatment, and effective viral suppression may be able to halt the ongoing HIV epidemic (ie, UNAIDS’ 95-95-95 targets) [6–8]; especially as evidenced by recent encouraging observations in Sydney [9]. Despite these promising efforts to limit further viral transmission, for PLWH, a “cure” remains elusive; whether it be to completely eradicate the viral reservoir (ie, cure) or to induce long-term viral remission in the absence of ART (ie, control; Figure 1). In a previous salon hosted by Pathogens and Immunity in 2016 [10], some researchers were optimistic that a cure was a feasible, scalable goal, albeit with no clear consensus on the best route. So, how are these cure strategies panning out? In this commentary, 8 years later, we will provide a brief overview on recent advances and failures towards identifying determinants of viral persistence and developing a scalable cure for HIV. Based on these observations, and as in the earlier salon, we have asked several prominent HIV cure researchers for their perspectives. https://www.paijournal.com/index.php/paijournal/article/view/665HIVSIVreservoirpersistenceARTHIV cure |
| spellingShingle | Justin Harper Michael Betts Mathias Lichterfeld Michaela Müller-Trutwin David Margolis Katharine Bar Jonathan Li Joseph McCune Sharon Lewin Deanna Kulpa Dázon Diallo Michael M. Lederman Mirko Paiardini Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? Pathogens and Immunity HIV SIV reservoir persistence ART HIV cure |
| title | Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? |
| title_full | Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? |
| title_fullStr | Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? |
| title_full_unstemmed | Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? |
| title_short | Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? |
| title_sort | progress note 2024 curing hiv not in my lifetime or just around the corner |
| topic | HIV SIV reservoir persistence ART HIV cure |
| url | https://www.paijournal.com/index.php/paijournal/article/view/665 |
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