We do not have a cure or a vaccine for the human immunodeficiency viruses, more commonly known as HIV, yet but existing treatments guarantee that people with the virus can live long and healthy lives. The management of the virus includes the use of multiple antiretroviral drugs, so there is an interest in making more streamlined and effective treatments.
A new potential long-acting treatment is reported in the journal Nature. Researchers have developed a small molecule called GS-6207, which targets the shell of the virus, the capsid, where the genetic material is enclosed. The designed molecule binds tightly to the capsid and this creates problems for the lifecycle of the virus, stopping it from replicating.
A major advantage of the drug is that it doesn’t have to be taken daily. Tests show that it remains active in the body for more than six months after administration, so researchers envision it to be injected under the skin twice a year. This is particularly advantageous in helping people keep up with treatment.
In laboratory tests, the drug has been shown to be effective against multiple strains of HIV, including variants that are resistant to current antiretroviral agents. It not only can be used as a treatment, but it might also be used preventatively in at-risk groups, similar to the way the Pre-exposure Prophylaxis (PrEP) pill works. The team describes it as “a potentially transformative tool in efforts to end the global HIV epidemic.”
While exciting, it is still early days. Firstly, the team ran a clinical study in 40 healthy individuals demonstrating that the drug is generally safe. A subsequent clinical trial was conducted in 32 patients with untreated HIV-1 and a single dose of GS-6207 reduced the viral load significantly in just nine days. It did not, however, lead to total clearance. Fortunately, the molecule can work together with approved antiretroviral drugs, so it could help as a combination treatment.
Achieving an undetectable viral load is key for treatments. It has been widely demonstrated that the many people that reach undetectable status cannot pass on the virus, a concept known as U=U or undetectable equals untransmittable.
It's an exciting step forward, but there is still much to be done to improve the lives of people with HIV. Health is more than the absence of disease and while people with HIV can live perfectly healthy lives they still have to face stigma and discrimination. Many people living with the virus still struggle to access treatments for many reasons, and it is crucial for the many social and economical barriers to be taken down.