Roger-Luc Chayer (Image : AI / Gay Globe)
Immunotherapy was already considered a future direction in oncology a few years ago, and it is now widely used to successfully treat many forms of cancer. Recently, several major breakthroughs have been announced, including impressive results against pancreatic cancer, one of the most aggressive and difficult-to-treat cancers.
Unlike chemotherapy, anticancer immunotherapy does not directly target the tumor. It works by mobilizing the patient’s immune system so it can recognize and destroy cancer cells. This fundamental difference explains why it is now at the core of modern medical research.
One of my neighbors was diagnosed with lung cancer a few years ago. As he responded very poorly to chemotherapy, he was enrolled in an experimental immunotherapy protocol at the Maisonneuve-Rosemont Hospital in Montreal. After a few infusions, his cancer completely disappeared and never returned. He died nearly ten years later from causes unrelated to the disease.
In this context, a question is now being raised in medical and scientific circles: could immunotherapy be used against HIV, the human immunodeficiency virus that has affected communities for decades, particularly gay men?
What is immunotherapy?
According to medical definitions, immunotherapy is a therapeutic approach aimed at stimulating or modifying the immune system so that it can better recognize and fight disease.
In the case of cancer, the goal is not to directly attack diseased cells as chemotherapy does, but rather to “re-educate” the body’s natural defenses. The immune system then learns to identify cancer cells as abnormal and eliminate them.
This strategy can involve several mechanisms: activation of immune cells, inhibition of natural immune checkpoints, or the use of laboratory-developed therapeutic antibodies. This personalized approach explains why results can be dramatic in some patients and more limited in others.
Immunotherapy and HIV: an emerging scientific avenue
Today, several researchers believe that certain approaches derived from cancer immunotherapy could open new perspectives in the fight against HIV. This is not yet a validated curative treatment, but rather promising research directions.
The main challenge with HIV lies in the formation of viral reservoirs. These infected cells escape the immune system and persist in the body, even when antiretroviral treatments make the virus undetectable in the blood. Stopping treatment almost always leads to viral rebound.
It is precisely on this point that anti-HIV immunotherapy aims to intervene. The goal is to strengthen or reprogram the immune response in order to identify and eliminate these hidden infected cells.
Among the approaches being studied are broadly neutralizing antibodies, capable of targeting multiple HIV variants. Immune checkpoint inhibitors, already used in oncology, are also being explored to reactivate T cells weakened by chronic infection.
In the same logic, CAR-T cell therapies against HIV involve genetically modifying immune cells to specifically target infected cells. Another strategy, known as shock and kill, aims to force viral reservoir cells to express the virus so they become visible to the immune system and can be eliminated.
Current limitations and advances in HIV research
Current results remain experimental, mainly observed in animals and early-stage clinical trials. HIV has a strong ability to mutate and hides in hard-to-reach areas such as lymph nodes or certain tissues of the nervous system.
Today, antiretroviral therapies (ART) remain the standard of care. They allow most people living with HIV to maintain a normal life expectancy, provided they are properly and consistently followed.
In this context, immunotherapy for HIV is being considered as a step toward a functional cure, meaning long-term control of the virus without daily treatment, before any possibility of complete eradication.
Toward a combined strategy against HIV
Research is moving toward a combined approach integrating antiretroviral therapy, immunotherapy, and gene therapies. This synergy could, in the long term, open the door to a genuine HIV cure strategy.
Significant advances have already been made with long-acting treatments, including extended-release injections that improve adherence and patients’ quality of life.
Among these innovations, lenacapavir (Sunlenca) represents a major breakthrough in the treatment of multidrug-resistant HIV. It works by blocking a key step in the viral replication cycle. It is also being studied for HIV prevention, although this use is not yet widely adopted.
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