Sustained HIV remission without antiretroviral therapy, the "top priority of research"

MADRID, 7 June (EUROPA PRESS) –

According to experts at the National Institute of Allergy and Infectious Diseases in the United States (NIAID), achieving sustainable remission of HIV without lifelong antiretroviral therapy (ART) is "the top priority of HIV research" . by its acronym) in an article published in the Journal of the American Medical Association.

Antiretroviral therapy involves taking a combination (usually three) of medications daily, often combined into one pill. This treatment has transformed the lives of people living with HIV, allowing those with access to medicines to live near normal lives.

Despite this success, side effects, pill fatigue, stigma and the cost of taking it daily, prompted researchers to find an alternative, say NIAID director Anthony S. Fauci and your team. they are looking for ways to achieve a complete and sustainable remission of HIV, so that daily antiretroviral therapy is "useless".

The authors say that feasible approaches should include minimal risk and manageable side effects for people living with HIV and should be affordable and scalable for millions of people. "A major barrier to sustained HIV remission without antiretroviral therapy is the persistence of viral reservoirs, made up of HIV-infected cells containing HIV genetic material that can generate new viral particles." The cells have entered a state of rest that they remain until they are activated to produce HIV, "they say.

Thus, they explain that two pathways are followed to achieve sustainable remission of HIV without antiretroviral therapy: total eradication of the HIV reservoir, classically referred to as "treatment", and prolonged virologic remission, which would control HIV replication. but would not eradicate it. the virus. The authors describe the specific strategies sought to achieve these goals.

Several approaches have been tried to eradicate the HIV reservoir, but none, with the exception of stem cell transplantation from a donor with a specific genetic mutation, has succeeded, and only in two cases. "The risks, cost and complexity of stem cell transplants make it difficult to eradicate the HIV reservoir in people who do not need such a transplant for an independent health problem under- ", they acknowledged.

Many strategies are under study to achieve prolonged virologic remission. The authors describe how some have the potential to replace daily antiretroviral therapy with an intermittent or continuous intervention not related to antiretroviral therapy, while others attempt to induce permanent immune system-mediated HIV control without the need for intervention. additional. Clinical trials of many different approaches are underway.