In light of World AIDS Day, here are 7 recent developments in the ongoing search for a cure, prevention, and treatments for HIV.

1. One patient’s blood is another’s (potential) cure

Scientists at the National Institute of Allergies and Infectious Diseases (NIAID) have made a significant discovery in the prevention and treatment of the highly contagious disease: the isolation of an antibody from a patient suffering from HIV. This antibody, termed N6, has neutralised 98% of HIV strains in vitro in a preclinical trial setting.

In addition, the antibody has been proven to be effective in countering up to 20 strains of HIV that previously was resistant to other antibodies of the same class. With such promising results, while still confined to the lab, this antibody or other recently-discovered proteins could provide the ever-elusive key towards future treatment and prevention methods.

2. Miniaturised testing kit

While early diagnosis is crucial for HIV treatment, for those living with the disease, tracking of one’s viral load in an easy and safe manner is also critical for a better quality of care. In addition, for poorer nations, HIV viral load tracking and detection is crucial due to the relatively underdeveloped healthcare systems.

This led a team of scientists from Imperial College London and DNA Electronics, who recently created such a device. Designed to be disposable, it resembles and is about the size of a USB stick. The device operates based on a mobile phone chip, and takes a drop of blood and determines the HIV viral load, which would then be transmitted via an electronic signal to be read digitally.

3. HIV prevention in a ring

As for HIV prevention, researchers have pioneered a vaginal ring that continuously releases the anti-HIV drug dapivirine has the potential to save lives, and prevent infection.

However, a social constraint remains. Researchers are questioning if such a device would remain under-utilised due to the stigma of wearing one. Although individuals in the ASPIRE study did not report much difference during sexual intercourse, but some participants reported that they “feared being interrogated in the middle of sex” if the ring is discovered by their partners during intercourse.

4. Research progress in cure for HIV and other viral infections

New research from Monash University has taken a step closer to a cure for HIV, and other viral infections, which in turn are associated with the development of lymphoma. The discovery involved discovering that killer T cells can find these "hidden" infected cells in tissue and destroy them.

The most hopeful news of them all is that these killer T cells are found naturally in the body during infection, but they are in short supply. However, for a cure based on this technique to work, such killer T cells must be boosted using human intervention. This research was significant in the fact that for the first time, a cure was in sight, a marked departure of the current lifelong treatment regime of being on antiretroviral drugs.

5. The first large-scale HIV vaccine trial

The National Institutes of Health of the United States has recently determined that an early-stage investigational HIV vaccine clinical trial regimen is safe, and has generated comparable immune responses to those reported in a landmark 2009 study showing that a vaccine can protect people from HIV infection.

Thus, the team of researchers and regulators have decided to proceed on to the advanced stages of this HIV vaccine regimen into a large-scale clinical trial. The purpose is to establish the safety, tolerability, and effectiveness of the vaccine in preventing HIV infection.

The Director of National Institute of Allergy and Infectious Diseases (NIAID), Anthony Fauci stated, “For the first time in seven years, the scientific community is embarking on a large-scale clinical trial of an HIV vaccine, the product of years of study and experimentation.”

6. Common approach to an unconventional vaccine

Researchers in Adelaide have shown that a combined approach of using a common cold virus to introduce a vaccine into the body, coupled with an injection of a DNA-based vaccine, can result in the immune system actively protecting against HIV in the body’s gut and cavities.

Currently only in the in-vitro stage, this represents a small but significant step in the attempt to create a first line defence against HIV at the point of infection.

7. Past failures, present learning

The landmark trial, termed as the STEP program, was halted prematurely due to initial results showing that those on the vaccine had a higher likelihood of being infected with HIV, compared to those on placebo.

The vaccine used the traditional method of creating a vaccine, but it was found that post-vaccination, the deactivated virus “hid” in the T cells. To make matters worse, now the virus had “an abundance of potential new homes at the sites where the virus would naturally enter the body during sexual intercourse, thereby increasing people's risk of infection.”

“It was vital to discover what caused this increase in HIV infection risk so we could avoid the same problem in future trials,” said Dr Steven Patterson, the corresponding author of the study from the Division of Investigative Science at Imperial College London. MIMS

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