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Review
. 2022 Jul 6;79(8):400.
doi: 10.1007/s00018-022-04421-z.

HIV cure strategies: which ones are appropriate for Africa?

Christopher Zaab-Yen Abana  1 , Helena Lamptey  2 , Evelyn Y Bonney  1 , George B Kyei  3   4   5
Affiliations
Review

HIV cure strategies: which ones are appropriate for Africa?

Christopher Zaab-Yen Abana et al. Cell Mol Life Sci. .

Abstract

Although combination antiretroviral therapy (ART) has reduced mortality and improved lifespan for people living with HIV, it does not provide a cure. Patients must be on ART for the rest of their lives and contend with side effects, unsustainable costs, and the development of drug resistance. A cure for HIV is, therefore, warranted to avoid the limitations of the current therapy and restore full health. However, this cure is difficult to find due to the persistence of latently infected HIV cellular reservoirs during suppressive ART. Approaches to HIV cure being investigated include boosting the host immune system, genetic approaches to disable co-receptors and the viral genome, purging cells harboring latent HIV with latency-reversing latency agents (LRAs) (shock and kill), intensifying ART as a cure, preventing replication of latent proviruses (block and lock) and boosting T cell turnover to reduce HIV-1 reservoirs (rinse and replace). Since most people living with HIV are in Africa, methods being developed for a cure must be amenable to clinical trials and deployment on the continent. This review discusses the current approaches to HIV cure and comments on their appropriateness for Africa.

Keywords: Africa; HIV cure; HIV latency; Reservoir.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the writing of the manuscript.

Figures

Fig. 1
Fig. 1
A world map indicating the regional HIV infections and breakdown of resources available for treating HIV at two-time points (2013 and 2020). Source of data: UNAIDS Financial Dashboard, 2021
Fig. 2
Fig. 2
Strategies under development for an HIV cure. A Shock and kill approach using latency-reversing agents (LRAs) to eradicate the latent reservoir. B Gene therapy utilizing CRISPR to target the latent reservoir. C Block and lock approach using latency-inducing agents to induce silencing of the latent reservoir. D Immune-based therapies using therapeutic vaccines, CAR-T cells, and broadly neutralizing antibodies. HDAC Histone deacetylase, HMT histone methyl transferase, PKC protein kinase C, dCA didehydro-cortistatin A, ART antiretroviral therapy
See this image and copyright information in PMC

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