Africa-Press – Botswana. Understanding the mechanisms that allow HIV to persist long-term is essential for advancing HIV cure research, especially in children who acquired the virus prenatally.
The sentiments were shared by the Botswana Harvard Health Partnership (BHP) senior research scientist Ms Catherine Koofhethile on July 9 at a symposium on advancing HIV cure research in Africa.
Presenting her current research which investigates the genetic makeup of HIV proviral reservoirs and the factors contributing to the virus’s persistence, Ms Koofhethile explained that the HIV reservoir, which is established early during infection, remains the major barrier to achieving a cure.
Ms Koofhethile elaborated that latently infected cells could harbour replication-competent proviruses where the virus remains transcriptionally silent.
She noted however that new data has shown that some proviruses can integrate into genes that remain active, enabling HIV to continue replicating.
“These cells can persist for a lifetime despite suppressive ART. Knowing where HIV integrates into the genome is crucial,. Some locations are silent; they are what we describe as ‘blocked and locked,while others allow for ongoing replication.”
Ms Keofhethile also discussed different potential HIV cure models.
“Type I controllers are individuals with no detectable intact proviruses, while Type II controllers possess intact proviruses integrated at sites with low transcriptional activity,” she said, adding that both types include individuals known as elite controllers.
Ms Koofhethile also highlighted Analytic Treatment Interruption (ATI) as another approach being explored in efforts to find an HIV cure. She said ATI involves pausing ART to observe whether the body can maintain control of the virus.
“Post-treatment controllers, those who began ART early and later interrupted it, have shown that HIV remission is possible, though rare,” she said.
She explained that remission and cure studies required treatment interruption, but that the time it takes for the virus to return varies widely, with the underlying reasons remaining unclear.
Professor Xu Yu of Harvard Medical School, whose work focuses on elite controllers, explained their significance in HIV cure research.
She described elite controllers as a rare group of people with HIV-1 who naturally suppress the virus to undetectable levels without the need for antiretroviral therapy.
The symposium brought together global health experts for an in-depth dialogue on advancing HIV cure research in Africa and it placed strong emphasis on HIV-1 cure research, particularly on the analysis of proviral reservoirs in adolescents and young adults from Botswana who have been on long-term antiretroviral therapy (ART) for nearly two decades.
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