Advances in HIV Treatment and Vaccine Development: Emerging Therapies and Breakthrough Strategies for Long-Term Control.

IF 1.8 Q4 INFECTIOUS DISEASES
AIDS Research and Treatment Pub Date : 2025-07-04 eCollection Date: 2025-01-01 DOI:10.1155/arat/6829446
Olalekan John Okesanya, Racheal Ahuoyiza Ayeni, Promise Amadin, Ifeanyi Ngwoke, Blessing Olawunmi Amisu, Bonaventure Michael Ukoaka, Mohamed Mustaf Ahmed, Tolutope Adebimpe Oso, Shuaibu Saidu Musa, Don Eliseo Lucero-Prisno
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引用次数: 0

Abstract

Since its identification in 1981, HIV has posed a global public health challenge, witnessing transformative advancements in treatment and prevention. This review summarizes recent novel therapeutic and preventive approaches for long-term HIV control, management, and elimination, and how global collaboration and technological innovations may advance HIV control efforts. This study highlights the progress and challenges in HIV treatment, emphasizing the effectiveness of current antiretroviral therapy (ART) in suppressing viral replication, reducing transmission, and preventing end-organ damage. However, adherence remains a significant barrier due to pill burden, side effects, and psychosocial factors affecting patients. ART-related toxicities include neuropathy, hepatotoxicity, metabolic disorders, and neuropsychiatric effects. Long-acting ART (LA-ART) offers a promising alternative to daily dosing; however, challenges such as injection site reactions persist. Broadly neutralizing antibodies (bNAbs) have shown enhanced efficacy in viral suppression and immune response activation, offering potential for treatment and vaccine design. Innovative gene-editing tools, such as CRISPR-Cas systems, are being explored for their ability to excise or silence proviral DNA; however, their clinical application is limited by off-target effects and delivery challenges. Latency-targeting strategies like "shock and kill" and "block and lock" remain experimental with limited clinical success, and nanotechnology-based drug delivery systems offer targeted, sustained, and less toxic treatment options. Despite the challenges posed by the virus's rapid mutation rate and immune evasion mechanisms, novel vaccine approaches, such as mRNA technology, vector-based platforms, and epitope-targeting strategies, are being explored. In addition, artificial intelligence and machine learning are enhancing the design of vaccines, predictive modeling, and fast-tracking progress in this area. Socio-economic bottlenecks in HIV control, such as stigma, gender disparities, and inequitable healthcare access, exacerbate the epidemic, particularly in sub-Saharan Africa. Enhancing global collaboration, providing sustainable funding, and integrating emerging and innovative technologies are critical for advancing HIV prevention and management. Achieving an AIDS-free generation and ultimately eliminating the epidemic will depend on effectively addressing the social, structural, and scientific barriers that hinder progress in this regard. Trial Registration: ClinicalTrials.gov identifier: NCT02120352, NCT02938520, NCT03639311, NCT03497676, NCT03635788.

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艾滋病毒治疗和疫苗开发的进展:长期控制的新兴疗法和突破性战略。
自1981年发现艾滋病毒以来,艾滋病毒对全球公共卫生构成了挑战,在治疗和预防方面取得了变革性进展。本文综述了近期用于长期控制、管理和消除艾滋病毒的新型治疗和预防方法,以及全球合作和技术创新如何促进艾滋病毒控制工作。本研究强调了HIV治疗的进展和挑战,强调了当前抗逆转录病毒治疗(ART)在抑制病毒复制、减少传播和预防终末器官损伤方面的有效性。然而,由于药物负担、副作用和影响患者的社会心理因素,依从性仍然是一个重大障碍。art相关的毒性包括神经病变、肝毒性、代谢紊乱和神经精神影响。长效抗逆转录病毒治疗(LA-ART)提供了每日给药的一种有希望的替代方案;然而,注射部位反应等挑战仍然存在。广泛中和抗体(bNAbs)在病毒抑制和免疫反应激活方面显示出增强的功效,为治疗和疫苗设计提供了潜力。人们正在探索创新的基因编辑工具,如CRISPR-Cas系统,因为它们能够切除或沉默原病毒DNA;然而,它们的临床应用受到脱靶效应和递送挑战的限制。像“休克和杀伤”和“阻断和锁定”这样的潜伏期靶向策略仍然处于试验阶段,临床成功有限,而基于纳米技术的药物输送系统提供了有针对性、持续和毒性较小的治疗选择。尽管病毒的快速突变率和免疫逃避机制带来了挑战,但人们正在探索新的疫苗方法,如mRNA技术、基于载体的平台和表位靶向策略。此外,人工智能和机器学习正在加强疫苗的设计、预测建模和该领域的快速进展。艾滋病毒控制方面的社会经济瓶颈,如耻辱、性别差异和不公平的医疗保健机会,加剧了这一流行病,特别是在撒哈拉以南非洲。加强全球合作、提供可持续资金以及整合新兴和创新技术对于推进艾滋病毒预防和管理至关重要。实现无艾滋病的一代并最终消除这一流行病,将取决于有效解决阻碍这方面进展的社会、结构和科学障碍。试验注册:ClinicalTrials.gov标识符:NCT02120352, NCT02938520, NCT03639311, NCT03497676, NCT03635788。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AIDS Research and Treatment
AIDS Research and Treatment INFECTIOUS DISEASES-
CiteScore
3.10
自引率
0.00%
发文量
13
审稿时长
18 weeks
期刊介绍: AIDS Research and Treatment is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focused on all aspects of HIV and AIDS, from the molecular basis of disease to translational and clinical research. In addition, articles relating to prevention, education, and behavior change will be considered
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