Klin Farmakol Farm. 2022;36(3):93-100 | DOI: 10.36290/far.2022.015

Is pharmacological eradication of HIV possible?

Svatava Snopková¹, Petr Husa¹, Šárka Kozáková²

¹ Klinika infekčních chorob FN Brno a LF MU Brno

² Ústavní lékárna FN Brno

The rapid onset of the global HIV pandemic at the turn of the 1980s and 1990s made the disease one of the most studied infectious diseases in the history of medicine. This was also reflected in the rapid development of effective antiretroviral drugs. Antiretroviral therapy has been in clinical practice since 1996. Treatment has significantly prolonged and improved the lives of people living with HIV, saving and still rescuing millions of people infected worldwide. However, after more than twenty years, it is evident that the treatment provided with the current pharmacotherapy is not entirely optimal and has its limits. Its potential is only suppressive, not eradicating. A specific feature of HIV is its ability to integrate its genome in the form of proviral DNA into the genome of the host cell. These cells do not induce the expression of viral antigens on their surface, the viral agent is not recognized by the immune system and is completely untouchable by antiretrovirals. The reservoir of latently infected cells consists of multiple cell types and tissue compartments, which become a barrier to effective treatment and possible eradication of HIV. Two basic directions of development of therapeutic intervention were defined - sterilization and functional. The ideal goal of sterilization treatment is to achieve the elimi­nation of active and latent viral agents from the human body. The goal of functional treatment is to induce long-term remission as a result of a strong host defense response mediated by immune mechanisms, even though the competent viral agent remains in the body. The text deals with the main areas of current research into new drugs and new treatment principles: long-acting slow-release antiretrovirals, immunotherapy, cell and gene therapy, shock and kill strategies, and block and lock strategies.

Keywords: HIV, antiretroviral therapy, HIV eradication, immunotherapy, neutralizing antibodies.

Accepted: November 3, 2022; Published: November 3, 2022  Show citation