A pioneering HIV cure trial is currently underway in KwaZulu-Natal (KZN), South Africa, targeting young women in one of the regions most heavily affected by HIV. Led by Professor Thumbi Ndung'u and his team at the Africa Health Research Institute (AHRI), the trial seeks to develop lasting solutions to the HIV/AIDS pandemic by intervening early in the course of infection.
The study involves administering antiretroviral (ARV) drugs to women immediately after they contract HIV, with the aim of preserving their immune systems. Following this, participants receive immune-boosting interventions designed to kill the virus and awaken dormant immune cells. The hope is that this strategy will lead to long-term control of the virus without the need for ongoing ARV therapy.
Addressing the HIV/AIDS Burden in Africa
Approximately 26 million of the 40 million people infected with HIV globally reside in Africa, highlighting the continent's disproportionate burden of the disease. While South Africa has seen a 50% reduction in new HIV infections between 2010 and 2021, largely due to the availability of free ARV therapy since 2004, long-term ARV use presents challenges, including cost and an increased risk of comorbidities such as metabolic disorders and cancer.
Professor Ndung'u emphasized the importance of research in finding a cure or vaccine, stating, "We must continue researching, or we will never make discoveries. Research gives us a chance."
Trial Design and Goals
The KZN trial represents a novel approach to HIV cure research. By initiating ARV treatment immediately upon infection, researchers aim to prevent the establishment of a large viral reservoir, which is a major obstacle to curing HIV. The subsequent immune-boosting interventions are designed to eliminate any remaining virus and enhance the body's natural ability to control HIV.
"Our hope is that this strategy will lead to long-term control of the virus without ARVs and help us understand mechanisms for controlling HIV without medication. This could be a significant step towards finding a cure," Ndung'u explained.
Global Context and Future Directions
Achieving the United Nations Sustainable Development Goal of ending the HIV/AIDS pandemic by 2030 requires a 90% reduction in new infections and AIDS-related deaths compared to 2010. With HIV infection rates rising in parts of Asia, Latin America, and Eastern Europe, research in Africa is crucial to maintain momentum and discover lasting solutions.
Professor Ndung'u cautioned that declining research efforts could reverse progress made in combating HIV/AIDS. He also noted that reaching the SDG target will require Africa to drastically reduce its infection rate, particularly among young women, who are disproportionately affected by HIV in the region.
