Chronic treatment of HIV using ART combinations prevents disease progression in most cases, but does not cure the infection and is costly, and once a person stops taking their medication, the virus reappears in a matter of weeks. Major goals of current research include eliminating the need for medication for people living with HIV, fully understanding how the virus works, and identifying new prevention strategies.
Eradication and functional cure
IrsiCaixa invests a large part of its efforts in finding a cure for HIV/AIDS so as to achieve natural infection control without the need for medication. This goal can be achieved in two ways: eliminating the viral potential to replicate and infect new cells, and reversing the immune dysfunction produced by the virus. IrsiCaixa’s focus is on designing strategies, or combinations of strategies, that achieve viral control, including therapeutic vaccines, cell therapies, synthetic antibodies, and drugs that reactivate latent virus or induce deep latency.
Viral reservoir studies
A main IrsiCaixa research objective is finding out how to identify, activate, and destroy viral reservoirs, as a definitive step towards HIV eradication. Current treatment has to be for life, because infection is reactivated when a person stops treatment due to HIV activity in reservoirs of cells where the virus remains latent. While the cell remains inactive, the viral reservoir remains invisible to the immune system and so ART fails to detect and remove it. Among other strategies, IrsiCaixa implements projects that seek to better understand the biology of viral reservoirs, to measure reservoirs accurately in both adults and children, and to functionally deactivate them.
The best strategy: prevention
All research aimed at eradication or functional cure is closely linked to research into HIV infection prevention, whether through preventive vaccines and drugs or through protective antibodies. With a view to developing preventive strategies, IrsiCaixa studies immune response in people at high risk of contracting HIV, and is working on the development of monoclonal antibodies that block HIV action in the body and boost the immune system activity of the natural killer cells responsible for destroying infected cells. In the future, these tools could form part of both an eradication and prevention strategy.