The hunt for a HIV cure is on

Now that Africa is turning the tide on HIV/Aids, with most new HIV infections occurring outside the continent, the hunt is on for a cure, says Professor Thumbi Ndung’u, an international expert on HIV/Aids and director of basic & translational science at the Africa Health Research Institute (AHRI) in KwaZulu-Natal.

World Aids Day has been marked annually on 1 December since 1988, to remind society of the need for global solidarity in the ongoing fight against HIV/Aids. 

“We’ve made tremendous progress. There are very effective HIV prevention and treatment methods, but there are nearly 40-million people, all over the world, living with HIV and that is not an easy thing. Most of those people live in Africa. We need new solutions,” says Ndung’u.

One of those new solutions is a vaccine against HIV; the other, a cure. These new approaches to the pandemic reflect that while antiretroviral (ARV) drugs have been enormously effective in preventing HIV transmission between people and in prolonging life for HIV-positive people, long-term ARV use is onerous for individuals, and expensive. People living with HIV, even when on antiretroviral therapy also tend to have higher incidence of comorbidities such as metabolic disorders and cancer compared to people without HIV.

In South Africa, ARV therapy has been provided free of charge through the public healthcare system since 2004. ARV treatment is the largest factor behind UNAIDS’s estimation that there has been a 50% drop in the number of new HIV infections in South Africa from 2010 to 2021. 

Globally, new HIV infections have dropped by 60% since their 1995 peak, according to UNAIDS, and Ndung’u says about 26-million of the nearly 40-million HIV-infected people across the globe live in Africa.

The third United Nations Sustainable Development Goal (SDG), which aims to ensure good health and well-being worldwide by 2030, has as one of its targets ending the HIV/Aids pandemic by that year. This will be achieved if the number of new HIV infections and Aids-related deaths decline by 90% between 2010 and 2030. The SDGs are a set of 17 goals that, if met, aim to ensure “peace and prosperity for people and the planet”.

Ndung’u says researchers are looking for a cure for HIV as an additional tool that may lead to eradication of Aids and control of HIV spread. However, decades of research on a vaccine for the virus have shown that finding immune-based solutions for the virus is not straightforward.

“We used to say that a vaccine was just around the corner,” he says. “But it’s hard to predict when we might develop one. That said, 30 years ago many would have been sceptical about us having effective medications.” 

A cure is also elusive. Only about seven people in the world have been cured of HIV, all of them after receiving bone marrow transplants after developing cancer. But, bone marrow transplantation is a radical, expensive and often dangerous procedure.

Ndung’u is involved in a cure trial involving young women in KwaZulu-Natal, one of South Africa’s most vulnerable demographics for HIV infection. 

The study is ongoing, but Ndung’u is hopeful. Through the study the AHRI treats women with ARVs very early after they acquire the HIV virus. This action preserves their immune systems. The women are then administered powerful immune-boosting interventions that can directly kill HIV and awaken immune cells where the virus hides when someone is taking antiretroviral medication. 

“Our hope is that this strategy will lead to long-term control of the virus in the absence of ARVs and that we can also better understand the mechanisms that may control the virus in the study participants without antiretroviral therapy. This would be a significant development and with time, it could lead us to a cure,” says Ndung’u.

It is vital that HIV/Aids research continues in Africa because, while the incidence of HIV-infection is reducing, this status quo could change at any time, says Ndung’u. To reach the SDG target on HIV/Aids, Africa must drastically reduce its infection rate.

Also, in Africa, HIV is a young woman’s disease, while in the regions where HIV infection is rising – Asia, Latin America and eastern Europe – infection most often occurs among men.

“We must continue researching, or we will never make discoveries. Research gives us a chance,” he says.

Sent in By:  Khaya Thwala

Issued by: Flow Communications on behalf of Africa Health Research Institute (AHRI).

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