On 1 December 2021 (Geneva, Switzerland) – IAS – the International AIDS Society – launched its latest strategy to find an HIV cure. Research Priorities for an HIV Cure: IAS Global Scientific Strategy 2021, was published on World AIDS Day, in the journal, Nature Medicine.
The third edition of the IAS strategy comes soon after it was announced that an Argentinean woman, known as the ‘’Esperanza patient’’, had been cured of HIV through natural immunity. This breakthrough has provided new hope for an HIV cure.
The curing of Timothy Ray Brown, also known as the “Berlin patient”, of HIV in 2008 inspired the IAS to set up the Towards an HIV Cure programme, founded by HIV co-discoverer and Nobel Laureate Françoise Barré-Sinoussi, in 2010. The aim is to drive concerted efforts to accelerate global scientific research and engagement towards a cure for HIV.
At AIDS 2012, the 19th International AIDS Conference, in Washington D.C., the IAS launched the inaugural Towards an HIV cure: A global scientific strategy, which established cure as a pillar of the global HIV response. An updated strategy was released in 2016. The latest iteration comes after a decade of progress, which saw Adam Castillejo (the “London patient”) cured via a stem cell transplant and two women seemingly cured through natural immunity. In addition, several interventions have shown great promise for a cure in animal models of HIV.
“It is clear that an HIV cure is achievable. The past five years of following the science have taught us that,” Adeeba Kamarulzaman, President of the IAS and Director of the Centre of Excellence for Research in AIDS at the University of Malaya in Malaysia, said.
“The recent case of the cured Esperanza patient adds a new dimension to our understanding of HIV controllers, those people who naturally control HIV without antiretroviral therapy. The challenge is to identify how commonly elimination of all intact virus occurs in elite controllers and what the mechanism is that makes that possible. We can then work out how we can replicate it on a broad scale. We need an HIV cure that works for everyone so we can end the HIV pandemic.
“The surfacing of the Omicron SARS-CoV-2 variant is a reminder to us all that vaccine inequity and our failure to end infectious diseases, such as HIV and tuberculosis, are the same side of the coin – a devaluation of human life in poor countries.’’
A 68-member IAS International Scientific Working Group developed the 2021 strategy over a year. The strategy reflects on progress made, identifies gaps in the research agenda, and outlines recommendations for HIV cure research over the next five years.
Despite the success of antiretroviral therapy (ART) for people living with HIV, lifelong treatment is required and there is no cure. HIV can integrate in the host genome and persist for the life span of the infected cell. These latently infected cells are not recognized as foreign because they are largely transcriptionally silent, but contain replication-competent virus that drives resurgence of the infection once ART is stopped. With a combination of immune activators, neutralizing antibodies, and therapeutic vaccines, some nonhuman primate models have been cured, providing optimism for these approaches now being evaluated in human clinical trials. In vivo delivery of gene-editing tools to either target the virus, boost immunity or protect cells from infection, also holds promise for future HIV cure strategies. In this Review, we discuss advances related to HIV cure in the last 5 years, highlight remaining knowledge gaps and identify priority areas for research for the next 5 years.
Download the full article here: Research priorities for an HIV cure: International AIDS Society Global Scientific Strategy 2021