Breakthroughs and advances in the fight against AIDS

With the help of and , the HIV/AIDS research community is increasingly turning its attention to the ambitious goal of finding a cure for HIV/AIDS.

If the world is to move closer to its goal of reducing HIV infections and AIDS-related deaths by 90% between 2010 and 2030, there will be major changes in the treatment of HIV/AIDS.

Much progress has been made in the fight against HIV/AIDS over the past 30 years. An HIV diagnosis is no longer the death sentence it was in the 1990s.

Antiretroviral treatments that target and suppress the replication of the virus in the body mean people living with HIV can transmit the HIV virus to others.

But even with antiretroviral treatment, living with HIV presents other serious health problems. All of this ultimately places an economic burden on the state and reduces workplace productivity.

South Africa is a good example of a country that could benefit from finding a cure. Provided by South Africa. This is the largest contributor to the number of new HIV infections in South Africa from 2010 to 2021.

However, the program is expensive. In 2023, South Africa had R30 billion (approximately US$1.5 billion). This amount includes funding from international sources such as , known as Pepfar. Consider that the total national health budget for the country in 2022/23 was (approximately USD 3.5 billion).

Additionally, we do not know when external funding, or any portion thereof, will run out. Funding for the HIV/AIDS response is . Recent political developments in high-income countries, such as the US presidential election, suggest a reluctance or even opposition to injecting funds into health care beyond their borders, particularly in Africa. I am doing it.

I am involved in research into HIV prevention and treatment. In particular, the study of understanding the interactions between HIV and the immune system and how these can be harnessed and translated into HIV prevention and treatment.

There is hope and optimism that HIV can be cured, and various strategies are beginning to show some promise, with partial success reported.

find a cure

Although research into treatments is still in its early stages, there are exciting hints that gene therapy and immunotherapy may lead to a cure.

So far, people around the world have been cured of HIV. They were HIV-infected people who developed cancer and were treated for their cancer with a bone marrow transplant, a form of gene therapy. This also helped eliminate HIV, since the bone marrow transplant was from a donor lacking the HIV coreceptor (a protein on cells). A surface that viruses use to bind to and enter cells.

But bone marrow transplants are , and . When we have reliable ART at hand, we cannot see it as a means to develop a cure. In contrast, several strategies involving combinations of early treatment and immunotherapy may be further developed for long-term control of HIV without antiretroviral therapy.

Viral infections are difficult to cure, but medicine has already been able to eradicate some viral infections, such as . Colds and other illnesses are effectively eliminated by a properly functioning immune system.

The problem with HIV is that it is particularly difficult to eliminate. That's also why developing a vaccine against it is so difficult.

This led us to explore the reasons why some people do not receive antiretroviral therapy and instead receive single or episodic treatments that boost the immune system. This appears to occur in some people who are diagnosed with HIV early in the infection, are immediately put on ART, then discontinue treatment, and at the same time receive special immune-boosting treatments with antiviral properties.

So far, the HIV research community cannot predict who will have this reaction, but the HIV Pathogenesis Program within the African Institute of Health Research and the University of KwaZulu-Natal is targeting a group of young women in KwaZulu communities. . Natal, South Africa, has a high rate of HIV infection.

These young women are participating in a socio-economic empowerment program where they attend clinics twice a week for training in basic computer skills, HIV prevention, and other life skills.

At each attendance, each woman is tested for HIV. If you are found to be infected with the HIV virus, you can immediately undergo a standard course of ART. After some time, immune-boosting therapy containing broadly neutralizing antibodies was added, after which women were asked to discontinue ART treatment under strict monitoring to see if they could control the virus on their own. You can If not, she will be returned to ART immediately. Since the study began 10 years ago, there have been 2,500 participants, 108 of whom have tested positive for HIV. Of these 108 people living with HIV, 20 are participating in clinical trials for a cure.

And our hope is that this strategy will lead to long-term control of the virus even in the absence of ART for some women. This will help us better understand the immune mechanisms that can control the virus without antiretroviral therapy, potentially leading to a cure.

Although much work still needs to be done, finding a cure is important, especially for people living with HIV around the world.

The world must meet the United Nations goal of ending the HIV/AIDS pandemic by 2030. Although HIV infection rates have decreased significantly, they are still much higher than the goals set by the global medical community. For example, in 2023, the goal of nearly eliminating HIV by 2030 will be achieved worldwide.

While continuing HIV/AIDS research in Africa is critical, this status quo could change at any time and we could return to fighting another pandemic. It would be better to use better tools to do it.

We also need to find treatments and vaccines tailored to Africa, while also seeking similar treatments and vaccines in regions such as Asia, Latin America and Eastern Europe.

We have a long game to play, but there's definitely hope and that's definitely something to celebrate.

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