4.3 Review

Immunotherapeutic approaches to HIV cure and remission

Journal

CURRENT OPINION IN INFECTIOUS DISEASES
Volume 35, Issue 1, Pages 31-41

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QCO.0000000000000803

Keywords

broadly neutralising antibody; cure; gene-editing; HIV; immunotherapies

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In recent years, advances have been made in understanding the persistence of latent HIV and developing more accurate assays for measuring the intact proviral reservoir. Broadly neutralising antibodies and techniques to enhance antibody responses have shown promising results. Other strategies such as therapeutic vaccination, latency reversal agents, and immunomodulatory agents have shown limited success, but newer interventions like engineered T cells may offer a potent strategy for achieving HIV cure.
Purpose of review Despite improvements in the effectiveness of antiretroviral therapy (ART), there are still unmet needs for people living with HIV which drive the search for a cure for HIV infection. The goal of this review is to discuss the challenges and recent immunotherapeutic advances towards developing a safe, effective and durable cure strategy for HIV. Recent findings In recent years, advances have been made in uncovering the mechanisms of persistence of latent HIV and in developing more accurate assays to measure the intact proviral reservoir. Broadly neutralising antibodies and modern techniques to enhance antibody responses have shown promising results. Other strategies including therapeutic vaccination, latency reversal agents, and immunomodulatory agents have shown limited success, but newer interventions including engineered T cells and other immunotherapies may be a potent and flexible strategy for achieving HIV cure. Although progress with newer cure strategies may be encouraging, challenges remain and it is essential to achieve a high threshold of safety and effectiveness in the era of safe and effective ART. It is likely that to achieve sustained HIV remission or cure, a multipronged approach involving a combination of enhancing both adaptive and innate immunity is required.

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