Over the past several decades, thousands of volunteers, community members, health professionals, and scientists have worked toward an HIV vaccine. While an effective HIV vaccine is still on the horizon, new effective treatments, prophylactics, and awareness have saved thousands of lives. In support of HIV Vaccine Awareness Day and those who work toward a potential vaccine, we’ve identified some of the best recent breakthroughs in HIV research.
Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system. If left untreated, HIV can lead to acquired immune deficiency syndrome (AIDS). Due to its prevalence and the lack of a cure (or a vaccine), there is a large global effort to develop effective vaccines and treatments. Many treatments and therapies are already available to stop or reduce virus development, transmission, or acquisition. These treatments are available for HIV-positive and HIV-negative individuals at risk of infection.
New antiretroviral therapy (ART) options, a growing awareness of prophylactics, and recent research findings may be the key to curbing the HIV epidemic.
Current Treatments and Therapies for HIV
Antiretroviral therapy has been available to treat HIV infection for over two decades. When used appropriately, ART is highly effective—it completely or nearly completely suppresses HIV replication, improves immune function, and reduces the risk of developing AIDS. It’s important to specify, however, that ART is not curative; if drug use is stopped, the virus invariably rebounds within weeks.
New forms of prophylactics have grown in popularity. Pre-Exposure Prophylaxis (PrEP) is a preventative method used by HIV-negative individuals at risk of contracting HIV. Post-Exposure Prophylaxis (PEP) refers to the use of preventative antiretroviral drugs for HIV-negative individuals after high-risk exposure to the virus. A lack of awareness previously limited the use of PrEP and PEP. However, new trends, initiatives, and drugs are being developed to protect at-risk HIV-negative individuals from contracting the virus.
Five Recent Advances in HIV Vaccine Research
Following are five recent advances that help reduce the burden of the HIV epidemic.
1. Growing Vaccine Research
The COVID-19 pandemic has demonstrated that vaccines and new technologies can be rapidly developed, tested, and distributed. While no HIV vaccine has made it past clinical trials, the road to an effective HIV vaccine is becoming shorter, and demand is growing. Scientists from the International AIDS Vaccine Initiative (IAVI) and Scripps research achieved promising results from Phase 1 clinical trials for a novel (and very efficient) vaccine that “can be designed to stimulate rare immune cells with specific properties” in humans. In addition, a team in Israel engineered type B white blood cells using CRISPR (clustered regularly interspaced short palindromic repeats) to trigger the immune system to fight the virus by producing more HIV-neutralizing antibodies. With such promising results (among others), an effective HIV vaccine may be a reality within the next few years.
2. Scientists Achieve a Better Understanding of the Characteristics of HIV
Scientists from the Salk Institute and Rutgers University have determined the molecular structure of HIV Pol polyprotein, which helps the virus propagate and spread throughout the body. Until now, the HIV Pol polyprotein was one of the critical missing pieces in understanding the structure of HIV. Researchers believe that this newfound discovery will help researchers understand the virus’s replication mechanism. This discovery may lead to the formulation of new drugs that could bind to the protein and block its function. This new understanding of the structure of proteins in HIV may allow researchers to formulate drug molecules that can bind to specific disease targets.
3. New Treatment Options for Adults with Multi-Drug Resistant HIV Infection
Despite recent advances in ART, there is a large number of patients with unsuitable treatment options due to multi-drug resistance. However, Gilead Sciences recently achieved marketing authorization from the European Commission for its six-month treatment option for HIV, Sunlenca (lenacapavir). Lenacapavir will be vital for adults with multi-drug resistant HIV who cannot easily build a suppressive anti-viral regimen. The lack of an effective anti-viral regimen puts these adults at greater risk of developing AIDS. This new treatment opens the door for patients with a difficult prognosis. Lenacapavir appears to have no known cross-resistance to other existing drug classes and could be beneficial for these patients with complex treatment histories.
4. First Injectable Treatment for HIV Pre-Exposure Prevention (PrEP)
In December 2021, the FDA approved the first injectable treatment for HIV pre-exposure prevention. Apretude (or cabotegravir extended-release injectable suspension) is used for PrEP to reduce the risk of sexually acquired HIV. This treatment is expected to contribute to the end of the HIV epidemic. It provides a more effective and easily managed PrEP treatment regimen for HIV-negative individuals who will only need a dosage every two months. This is in contrast to the conventional daily pill format. Daily medication adherence is a significant challenge for many patients, including men who have sex with other men (clinically referred to as MSM), especially among younger cohorts. The FDA expects that the availability of long-acting injectable PrEP options will increase PrEP uptake and adherence.
5. Growing Acceptance and Awareness of Treatments, Prophylactics, and Clinical Trials
Recent studies have reported a greater awareness and willingness among MSM to participate in clinical trials for HIV cures. A 2022 Hong Kong study found that MSM that live with HIV, especially those that are sexually active, were more motivated to participate in clinical trials for HIV functional cures. A key finding indicated that advice from healthcare professionals was a crucial factor in the willingness of patients to join clinical trials. A similar study found that post-exposure prophylaxis (PEP) was also underused and had low awareness among MSM. However, once they became aware of PEP, the majority were willing to use it if given support. Another study suggested that targeting MSM through web-based platforms and the parallel development of tailored HIV testing services were vital to introducing PrEP to the community. The same would also apply to PEP to help spread awareness of prophylaxis for individuals who are at risk of contracting HIV.
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