In the rapidly evolving field of HIV/AIDS research, 2022 marked a significant year for advancements in care, treatment and prevention. With successful trials, new antiretroviral therapies (ARTs) and the detection of new antibodies, researchers worldwide take one step closer to a more effective and accessible medical regimen for infected individuals. Here are the top five ameliorations in HIV/AIDS treatment this year.
1. Stem-cell Transplants as a Treatment Option
Stem cell research has become increasingly popular over the past few decades due to its limitless potential in medical treatments. Dr. Roger Shapiro, a professor of immunology at Harvard T.H. Chan School of Public Health, describes the clinical trial that was completed earlier this year using a stem cell transplant. The 66-year-old man with HIV and acute myelogenous leukaemia is the fourth known person to go into HIV remission.
Shapiro comments, “So we are up to about 5 patients now who have been cured or put into remission by a specific scientific intervention. These are small numbers, but each case helps us gain confidence that these lines of research hold promise.” After 12 months post treatment, the patient was found to have no detectable HIV DNA. Additionally, the individual’s leukaemia had also been cured by the transplant. The success of the clinical trial was revolutionary for physicians managing HIV/AIDS cases. Further developments in stem-cell transplants for HIV/AIDS patients may change the trajectory of treatment options in the near future.
2. Mobilizing the Human Immune System: bNAbs
Broadly neutralizing antibodies (bNAbs) are created in laboratories to treat and prevent HIV. These antibodies recognize and obstruct the entry of various HIV strains into healthy cells, while simultaneously activating other immune cells to destroy HIV-infected cells. The inclusion of bNAbs in HIV/AIDS treatment mimics the course of a vaccine, with the potential to be stronger and more efficient than typical drug or injection supplements.
Advances in bNAbs this year led to the conclusion that two potent antibodies can maintain viral suppression without the need for standard antiretroviral treatments (ARTs). This is largely significant for patients undergoing frequent ARTs that often take clinical visits multiple times a month.
bNAbs in action under a microscope. Image retrieved from https://www.nature.com/articles/d42859-018-00020-w
3. Discovery of Lenacapavir and Other Long-acting Injectable Antiretroviral Therapies
Cabenuva (consisting of cabotegravir & rilpivirine), is an injectable intramuscular antiretroviral treatment that is a commonly prescribed medication for HIV/AIDS patients taken once a month.
This year, researchers began to study lenacapavir, a drug that could potentially become a powerful new class of long-acting antiretroviral therapies. Lenacapavir is administered every six months and is effective for those previously treated with other medication, and, for those starting antiretrovirals for the first time. Although the drug has yet to be approved, the new medication could replace Cabenuva due to its less frequent administration, and its simplicity over Cabenuva and other HIV/AIDS pills.
4. Ameliorations in Pre-Exposure Prophylaxis (PrEP) Medication
A clinical trial involving the PrEP drug doxycycline proved to be successful for those at a higher risk to prevent other bacterial STIs. The study was composed of individuals who were biologically male at birth, living with HIV with a history of STI & condomless sex with a male partner within the past year. Two thirds of participants took doxycycline while one third resumed standard care without the PrEP drug.
After administering 200 mg of oral doxycycline within 72 hours after condomless sex, results displayed a vast reduction of other STIs including syphilis, gonorrhea & chlamydia. 65% of those randomized to take the PrEP drug were not diagnosed with an STI compared to those who did not take doxycycline. The evidence from this study shows promising results in HIV/AIDS prevention.
5. Greater HIV/AIDS testing accessibility in third-world countries
The majority of HIV/AIDS cases lie in third-world countries, such as Sub-Saharan Africa; regions that lack accessible health care and preventative medication. Efforts by the Botswana government in terms of surveying and HIV/AIDS awareness made the country a popular region of study this year.
The survey concluded that 95.1% of Botswanans living with HIV/AIDS were aware of their status and 98% of those individuals made efforts to get antiretroviral therapy. As a result of these positive outcomes, the Botswana government expanded treatment coverage in 2022, providing free HIV treatment and testing to all citizens with the help of the UNAIDS program.
Madisa Mine, an ambassador of the Botswana Ministry of Health & Wellness states, “the country is well-positioned to end its HIV epidemic by 2030.”
Statistics of child mortality in Botswana, relative to HIV exposure. Image retrieved from https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2418/2016/09/HEU-Babies3-1024x640.png
The advancements made in HIV/AIDS treatment and prevention in 2022 paved the way for groundbreaking new medications that could aid the global HIV/AIDS crisis. Grand improvements present greater optimism for what’s in store for the new year.
References
Goodenow, M.M. (2022, August 15). NIH HIV Research – Highlights at AIDS 2022. HIV.gov. Retrieved January 6, 2023, from https://www.hiv.gov/blog/nih-hiv-research-highlights-aids-2022.
Mastroianni, B. (2022, December 22). HIV: 2022’s Advancements in Research, Care and Prevention. Healthline. Retrieved January 6, 2023, from https://www.healthline.com/health-news/hiv-2022s-advancements-in-research-care-and-prevention#Pushes-for-a-vaccine-have-had-mixed-results-in-2022.
Van Lunzen, J., Leone, P., & Losos, J. How do you spell the next generation of HIV treatments? Could it be BNAB? ViiV Healthcare. Retrieved January 6, 2023, from https://viivhealthcare.com/ending-hiv/stories/science-and-innovation/exploring-bnabs-as-new-hiv-treatment/#:~:text=Broadly%20neutralising%20antibodies%20(bNAbs)%20are,help%20destroy%20HIV%2Dinfected%20cells.
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