COMBATING HIV

Initiative at a glance

HIV continues to be a major global public health issue, having claimed 40.1 million lives so far. In the year 2021 650 000 people died from HIV-related causes globally. There were approximately 38.4 million people living with HIV (PLHIV) at the end of 2021 with 1.5 million people becoming newly infected with HIV in 2021 globally. The WHO African Region is the most affected region, with 25.6 million people living with HIV in 2021. Also, the WHO African Region accounts for almost 60% of the global new HIV infections. In 2021,28.7 million people living with HIV were receiving anti-retroviral therapy (ART) globally. ART for the treatment of HIV infection has improved steadily since the advent of potent combination therapy in 1996. ART has dramatically reduced HIV- associated morbidity and mortality and has transformed HIV infection into a manageable chronic condition, with life expectancy approaching that for people without HIV.

More than 30 anti-retroviral (ARV) drugs in eight mechanistic classes are U.S. Food and Drug Administration (FDA)- approved for treatment of HIV infection. Increased use of HIV medicines has been accompanied by the emergence of HIV drug resistance, the levels of which have steadily increased in recent years. HIV drug resistance is caused by changes in the genetic structure of HIV that affect the ability of medicines to block the replication of the virus.

All anti-retroviral drugs, including those from newer drug classes, are at risk of becoming partially or fully inactive due to the emergence of drug-resistant virus. If not prevented, HIV drug resistance can jeopardize the efficacy of medicines used to treat HIV, resulting in increased numbers of HIV infections and HIV-associated morbidity and mortality. Drug resistance can be found in some people before they begin treatment. This resistance can either be transmitted at the time of infection or be acquired during previous treatments, for example in women given antiretroviral medicine to prevent mother-to-child transmission of HIV.

Our initiative aims to understand the diagnostic capacity of our own immune system to react to whatever is changing within our body. Developing HIV drug resistance is directly liked to the emerging viral burden within the bloodstream and thus and immediate change within the composition of the immune system. Once we can monitor these marginal changes within the immune system via repertoire analysis, we can predict the onset of HIV drug resistance without even having detectable HIV viral levels while HIV treatment.