Combining antiretroviral drugs and immune therapies: an approach to achieve clinical benefit after treatment interruption

Curr Opin HIV AIDS. 2008 Mar;3(2):104-11. doi: 10.1097/COH.0b013e3282f50c21.

Abstract

Purpose of review: In the next 5-10 years, neither antiviral drug treatment nor a preventive vaccine is expected to provide a solution to the HIV epidemic. To achieve a relevant public health benefit, it is time to change focus and develop immune therapies to achieve a beneficial viral load reduction in the absence of drugs.

Recent findings: Induction of long-term immune control with only limited rebounds of the wild-type HIV virus was found to be feasible and achievable, albeit in very limited cases. This review provides an analysis of the past achievements and an overview for the present therapeutic approaches under clinical development that could succeed to suppress viral replication after treatment interruption.

Summary: Interruption of antiretroviral treatment results in rapid viral load rebound and disease progression. There is no immune therapy on the market for the treatment of HIV that could lower the viral load set point by over 0.5 log to provide significant clinical benefit. A lower viral load maintained by the patient's own immune system following treatment interruption could offer a favorable prognosis and represent an alternative additional approach to antiretroviral drugs.