The main barrier to a cure for HIV is the reservoir of persistent virus that remains dormant in both blood and tissue, beyond the reach of antiretroviral therapy and the immune system. Researchers are working to resolve key questions, such as how to activate HIV-infected reservoir cells, how to make them vulnerable to attack by the immune system, and how to eradicate them altogether.
Before testing an agent or therapeutic approach in human subjects, researchers first need to show proof of concept or characterize how the agent behaves in the laboratory or in test animals. amfAR-funded researchers are testing a variety of approaches, such as boosting the immune system, gene therapy, and CAR T cells, which have proven highly successful in the treatment of certain types of cancer.
Cure researchers need to evaluate how any agent or approach works in the human body over time. Much can be learned from the handful of cures achieved to date through stem cell transplantation and from those who are somehow able to clear or control their infection without outside intervention. Clinical trials are also necessary to determine how cure strategies might be combined to work together, for example.
Until we have a cure that is widely accessible, preventing HIV transmission relies on both biomedical and behavioral interventions. In the absence of a safe and effective vaccine, this includes use of condoms, pre-exposure prophylaxis (PrEP), voluntary medical male circumcision, and syringe exchange programs for people who inject drugs.
amfAR funded studies that led to the development of four of the six classes of antiretroviral drugs used today to help people living with HIV achieve viral suppression (or in some cases prevent HIV infection in people who are negative). This field of research has not been exhausted, and researchers are studying new ways to interrupt the HIV lifecycle.
Any cure strategy in development will need to take into account differences across people living with HIV—different subtypes of virus, treatment experience, age, and gender, among other factors—in order to ensure that a cure works for everyone.
Studies of the intersection of HIV and COVID-19, cardiovascular disease, kidney disease, hepatitis, and brain impairment, among other conditions, are needed to improve health outcomes for people living with HIV, especially as they age.
Cure research is a person-centered enterprise. Perspectives of researchers and scientific leaders, and people living with HIV/AIDS are invaluable, not only for the wider public to understand their experiences, needs, and priorities, but also to highlight their meaningful involvement in this urgent project.
amfAR supports two types of grants: target grants, awarded to researchers studying potential HIV cure interventions, and Mathilde Krim Fellowships in Biomedical Research, awarded to early career scientists who show promise in the field of HIV research.