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Addressing an HIV cure in LMIC

HIV-1 persists in infected individuals despite years of antiretroviral therapy (ART), due to the formation of a stable and long-lived latent viral reservoir. Early ART can reduce the latent reservoir and is associated with post-treatment control in people living with HIV (PLWH). However, even in pos...

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Autores principales: Ismail, Sherazaan D., Pankrac, Joshua, Ndashimye, Emmanuel, Prodger, Jessica L., Abrahams, Melissa-Rose, Mann, Jamie F. S., Redd, Andrew D., Arts, Eric J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330180/
https://www.ncbi.nlm.nih.gov/pubmed/34344423
http://dx.doi.org/10.1186/s12977-021-00565-1
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author Ismail, Sherazaan D.
Pankrac, Joshua
Ndashimye, Emmanuel
Prodger, Jessica L.
Abrahams, Melissa-Rose
Mann, Jamie F. S.
Redd, Andrew D.
Arts, Eric J.
author_facet Ismail, Sherazaan D.
Pankrac, Joshua
Ndashimye, Emmanuel
Prodger, Jessica L.
Abrahams, Melissa-Rose
Mann, Jamie F. S.
Redd, Andrew D.
Arts, Eric J.
author_sort Ismail, Sherazaan D.
collection PubMed
description HIV-1 persists in infected individuals despite years of antiretroviral therapy (ART), due to the formation of a stable and long-lived latent viral reservoir. Early ART can reduce the latent reservoir and is associated with post-treatment control in people living with HIV (PLWH). However, even in post-treatment controllers, ART cessation after a period of time inevitably results in rebound of plasma viraemia, thus lifelong treatment for viral suppression is indicated. Due to the difficulties of sustained life-long treatment in the millions of PLWH worldwide, a cure is undeniably necessary. This requires an in-depth understanding of reservoir formation and dynamics. Differences exist in treatment guidelines and accessibility to treatment as well as social stigma between low- and-middle income countries (LMICs) and high-income countries. In addition, demographic differences exist in PLWH from different geographical regions such as infecting viral subtype and host genetics, which can contribute to differences in the viral reservoir between different populations. Here, we review topics relevant to HIV-1 cure research in LMICs, with a focus on sub-Saharan Africa, the region of the world bearing the greatest burden of HIV-1. We present a summary of ART in LMICs, highlighting challenges that may be experienced in implementing a HIV-1 cure therapeutic. Furthermore, we discuss current research on the HIV-1 latent reservoir in different populations, highlighting research in LMIC and gaps in the research that may facilitate a global cure. Finally, we discuss current experimental cure strategies in the context of their potential application in LMICs.
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spelling pubmed-83301802021-08-04 Addressing an HIV cure in LMIC Ismail, Sherazaan D. Pankrac, Joshua Ndashimye, Emmanuel Prodger, Jessica L. Abrahams, Melissa-Rose Mann, Jamie F. S. Redd, Andrew D. Arts, Eric J. Retrovirology Review HIV-1 persists in infected individuals despite years of antiretroviral therapy (ART), due to the formation of a stable and long-lived latent viral reservoir. Early ART can reduce the latent reservoir and is associated with post-treatment control in people living with HIV (PLWH). However, even in post-treatment controllers, ART cessation after a period of time inevitably results in rebound of plasma viraemia, thus lifelong treatment for viral suppression is indicated. Due to the difficulties of sustained life-long treatment in the millions of PLWH worldwide, a cure is undeniably necessary. This requires an in-depth understanding of reservoir formation and dynamics. Differences exist in treatment guidelines and accessibility to treatment as well as social stigma between low- and-middle income countries (LMICs) and high-income countries. In addition, demographic differences exist in PLWH from different geographical regions such as infecting viral subtype and host genetics, which can contribute to differences in the viral reservoir between different populations. Here, we review topics relevant to HIV-1 cure research in LMICs, with a focus on sub-Saharan Africa, the region of the world bearing the greatest burden of HIV-1. We present a summary of ART in LMICs, highlighting challenges that may be experienced in implementing a HIV-1 cure therapeutic. Furthermore, we discuss current research on the HIV-1 latent reservoir in different populations, highlighting research in LMIC and gaps in the research that may facilitate a global cure. Finally, we discuss current experimental cure strategies in the context of their potential application in LMICs. BioMed Central 2021-08-03 /pmc/articles/PMC8330180/ /pubmed/34344423 http://dx.doi.org/10.1186/s12977-021-00565-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Ismail, Sherazaan D.
Pankrac, Joshua
Ndashimye, Emmanuel
Prodger, Jessica L.
Abrahams, Melissa-Rose
Mann, Jamie F. S.
Redd, Andrew D.
Arts, Eric J.
Addressing an HIV cure in LMIC
title Addressing an HIV cure in LMIC
title_full Addressing an HIV cure in LMIC
title_fullStr Addressing an HIV cure in LMIC
title_full_unstemmed Addressing an HIV cure in LMIC
title_short Addressing an HIV cure in LMIC
title_sort addressing an hiv cure in lmic
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330180/
https://www.ncbi.nlm.nih.gov/pubmed/34344423
http://dx.doi.org/10.1186/s12977-021-00565-1
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