Immunotherapy for HIV: A New Treatment Path?

Arnaud Pontin Contributor to Gay Globe Media. He brings a journalistic perspective focused on social and cultural realities, with a structured and methodical approach. His work emphasizes fact-checking, data verification, and clear analysis aimed at making complex topics accessible and well contextualized.

Arnaud Pontin (Image : Pixabay)

The more medical research advances, the more the results overlap, and we are increasingly realizing that research in one field can deliver results in other fields. An excellent example is that of cancer, which has produced very interesting results in the field of HIV, even making it possible to design new drugs.

Immunotherapy has revolutionized the medical field by making it possible, in some cases, to replace or complement heavy treatments such as chemotherapy with treatments that are generally better tolerated by the body, particularly in certain cancers of the lung, throat, or colon.

An example of these successes is that of a close neighbor who was diagnosed with throat and lung cancer about 10 years ago after many years of smoking cigarettes. He had consulted his doctor because he had lost his voice and was experiencing discomfort in his throat. After several examinations, his cancer was diagnosed and he was immediately prescribed a series of chemotherapy treatments that caused significant side effects.

After a few treatments, he decided not to continue with his treatment, preferring to end things with less suffering. But his oncologist then told him about an experimental treatment based on immunotherapy which, according to the principle behind the treatment, was supposed to stimulate or mobilize his own immune system so that it could better recognize and fight cancer cells. There were risks, but the treatment involved far fewer side effects. He agreed.

After a very short series of treatments by infusion, within a few weeks in fact, he regained his voice and was feeling better and better, particularly regarding the discomfort in his throat. Even once immunotherapy treatments have ended, their effects can continue, since the immune system can continue to recognize and fight cancer cells. This is one of the most remarkable characteristics of this approach.

Two years later, a scan of the affected areas was performed to measure the effects of the experimental treatment. The smile on the doctor’s face said it all: there was no longer any sign of active cancer. The only visible traces consisted of scar tissue, remnants of the battle between his immune system and his cancer.

Could immunotherapy represent a new treatment pathway against HIV?

For decades, the fight against HIV has relied primarily on antiretroviral treatments. These medications have completely transformed the prognosis for people living with the virus: when taken correctly, they suppress HIV replication, maintain an undetectable viral load, and prevent sexual transmission of the virus.

But one difficulty remains: antiretroviral drugs do not completely destroy the HIV present in the body. The virus can hide in certain cells in a dormant form, forming what researchers call the viral reservoir. If treatment is stopped, these reservoirs can allow the virus to resume multiplying. This is precisely where immunotherapy could change the game.

Cancer research has considerably increased our ability to use the immune system to recognize and destroy abnormal cells. Cancer immunotherapies have notably made it possible to develop specialized antibodies, treatments capable of stimulating T lymphocytes, and genetically modified immune cells to target certain cancer cells.

Researchers are now trying to adapt some of these technologies to HIV. The goal is no longer simply to prevent the virus from multiplying, but to make the cells containing HIV visible and allow the immune system to eliminate them.

One of the strategies being studied is sometimes summarized by the expression “kick and kill.” The principle consists of reactivating dormant HIV in certain cells so that it can be recognized, and then using the immune system or targeted therapy to destroy these cells. The concept seems simple, but its implementation is extremely complex. The viral reservoir consists of relatively rare cells, scattered throughout different tissues and capable of preserving the virus in a form that is difficult to detect.

Antibodies capable of targeting HIV

Broadly neutralizing antibodies, known as bNAbs, represent another particularly studied avenue. Some of these antibodies can recognize many variants of HIV. They can directly neutralize the virus, but some may also help signal infected cells to the immune system so that they can be destroyed.

Researchers are particularly studying combinations of antibodies and their association with other immune treatments. The objective would eventually be to achieve durable HIV remission without having to rely permanently on antiretroviral drugs.

It is not yet a treatment available in clinical practice, however. These approaches remain experimental and are the subject of trials designed to determine their effectiveness and safety.

Could T lymphocytes become weapons against HIV?

Another avenue draws directly from certain immunotherapies used against cancer: genetically modified immune cells. CAR-T treatments, developed primarily in oncology, involve modifying T lymphocytes so that they can recognize certain characteristics of cancer cells and attack them.

Researchers are exploring a comparable idea against HIV: modifying T lymphocytes so that they can identify virus-infected cells more effectively. This approach is particularly interesting because it could theoretically allow the immune system to attack the viral reservoir itself rather than simply preventing the virus from reproducing.

What if the immune system could learn to control HIV?

Therapeutic vaccines represent another branch of this research. Unlike preventive vaccines, which seek to prevent an infection before it occurs, a therapeutic vaccine would be intended for a person who already lives with HIV.

The goal would be to stimulate or redirect the immune response so that the body could better control the virus. Once again, no therapeutic vaccine against HIV is currently approved as a treatment that can replace antiretroviral drugs. But this approach is part of the strategies being studied in the search for a functional cure for HIV.

A complete cure or durable remission?

This is an important distinction. Scientists are not necessarily seeking, initially, to eliminate every copy of HIV present in the body. A first step could be to achieve durable remission, meaning keeping the virus under control without daily antiretroviral treatment.

The ultimate goal would obviously be complete eradication of the virus, but this is much more difficult to achieve because of the persistence of viral reservoirs.

A future strategy could therefore combine several technologies: antiretroviral drugs, broadly neutralizing antibodies, immune stimulation, genetic modification of T lymphocytes, and other treatments capable of targeting reservoirs. It would nevertheless be an exaggeration to claim that cancer treatments will simply be transferred to HIV. HIV and cancer are very different diseases and their biological mechanisms are not interchangeable.

But the two fields share one fundamental element: the ability of the immune system to recognize a cell that must be destroyed.

Cancer research has made it possible to develop extremely sophisticated tools for manipulating this immune response. Some of this knowledge can now be applied to HIV research. The real challenge is to identify the cells containing dormant HIV precisely enough to eliminate them without causing significant damage to healthy cells.

Immunotherapy therefore does not currently replace antiretroviral treatments. For people living with HIV, these remain the foundation of treatment and today allow a long and healthy life when properly used. But research is evolving.

After learning to control HIV, scientists are now trying to understand how to reduce or eliminate the reservoirs that allow the virus to persist.

Immunotherapy could play a major role in this next step. And one of the great lessons from cancer research could well be applied to HIV: rather than fighting the virus only with drugs, it may one day be possible to give the immune system the tools it needs to find the infected cells itself and destroy them.

That day has not yet arrived. But unlike the early years of the epidemic, research now has biological tools that make it possible to seriously consider this possibility.

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