Munich, Germany — A cure for HIV is critically important for Africa due to the continent's heavy burden from the disease. Africa bears a disproportionately high HIV prevalence, with around 8 million people living with HIV in South Africa alone. Life expectancy and quality of life improved significantly with antiretroviral therapy, but the search for a cure continues.
A multinational team led by Weill Cornell Medicine investigators developed a tool that is crucial in the global search for an HIV cure. Most HIV research focuses on strains prevalent in Western countries, particularly subtype B, affecting mainly men who have sex with men. In contrast, fewer studies examine the strains circulating in Africa, where women are disproportionately impacted.
Dr. Guinevere Lee, assistant professor of virology in medicine in the Division of Infectious Diseases and assistant professor of microbiology and immunology at Weill Cornell Medicine, and her team analyzed DNA from immune cells called CD4+ T cells, where viral DNA hides, of 16 women and 7 men receiving antiretroviral HIV treatment in Uganda, Nature reports.
The research revealed that similar to findings in developed countries, HIV strains in Africa create viral reservoirs in the human body. While antiretroviral therapy can reduce HIV to undetectable levels in the blood, these dormant reservoirs persist. They contain many defective proviral DNA genomes incapable of producing new infectious viruses. However, a small number of genomes remain genetically intact and can produce active viruses if antiretroviral treatment is halted.
Dr Lee described the process as "looking for a needle in a haystack", but their newly developed laboratory test finds and measures the amount of "genome-intact proviruses remain in the body during antiretroviral treatment". This allows them to measure the persistence of HIV in individuals affected by viral strains predominantly found in Africa.
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"The new assay we've developed will help researchers home in on the intact proviral genomes relevant to HIV cure research for patients affected by these under-studied strains," Dr. Lee told Nature.
Dr. Lee and her multinational, multi-institution collaborators are already using the new laboratory test to study long-term viral persistence in Uganda.
Treatments for HIV suppress the virus, but it doesn't eliminate it.
It is estimated that 39.9 million people worldwide are living with HIV, around 70% of whom are in Africa. While progress has been made in reducing new HIV infections, cases are still increasing in the Middle East and North Africa, Eastern Europe and Central Asia, and Latin America. The report "The Urgency of Now: AIDS at a Crossroads" points out that achieving effective HIV prevention and treatment requires upholding human rights, eliminating discriminatory laws against women and marginalized groups, and addressing stigma and violence.
Despite significant progress in combating the HIV epidemic, the high infection rates among women and girls in sub-Saharan Africa, along with childhood HIV infections, continue to impede overall progress.
