HIV treatment has transformed the infection from a death sentence into a manageable chronic condition. Today's antiretroviral therapy usually means one pill a day that keeps the virus undetectable and untransmittable. Research now focuses on longer-acting treatments, functional cures, and eradicating the virus entirely.
What's actually going on in research
Trials are testing long-acting injections given every few months, broadly neutralizing antibodies that target multiple HIV strains, gene therapies to disable the virus permanently, and therapeutic vaccines to teach the immune system to control HIV without daily medication. Researchers are also studying latency reversal strategies to flush out hidden virus reservoirs and destroy them.
Long-acting medications
Cabotegravir and rilpivirine injections every two months are FDA-approved, and trials are testing injections that last six months. Lenacapavir, a capsid inhibitor, is approved as part of daily regimens and being studied as a twice-yearly injection.
Broadly neutralizing antibodies
These engineered antibodies bind to parts of HIV that don't mutate easily, potentially controlling the virus for months after a single infusion. Studies are combining multiple antibodies to prevent resistance.
Cure research
Gene therapies aim to remove or disable the CCR5 receptor that HIV uses to enter cells, mimicking the natural resistance seen in a small number of people. Other approaches try to wake dormant virus and eliminate it while the immune system is supported.
What to know before you search
Eligibility typically depends on viral load, CD4 count, prior antiretroviral regimens, resistance test results, and whether you've maintained an undetectable viral load.
What types of trials are currently open
- Treatment trials — Testing new antiretroviral drugs or combinations, often comparing pills to long-acting injections or evaluating whether treatment can be simplified.
- Cure trials — Testing gene therapies, therapeutic vaccines, or immune-based treatments that might allow people to control HIV without daily medication or eliminate the virus entirely.
- Antibody trials — Studies of broadly neutralizing antibodies given by infusion, alone or combined with other treatments, to see if they can suppress HIV for extended periods.
- Prevention trials — Testing long-acting medications or antibodies to prevent HIV infection in people at high risk, building on the success of daily oral PrEP.
- Observational studies — Following people living with HIV to understand long-term health outcomes, side effects, and how the virus behaves in different populations.
Recently added HIV trials
Platelets Target the Circulating HIV Reservoir: Implications for Immunological Failure
HIV/AIDS is a chronic disease that is difficult to eradicate because the virus persists as proviral DNA integrated into the host cells. Despite antiretroviral therapy, proviral DNA persists in lymphoid and myeloid reservoirs, whether circulating (memory CD4+ T cells) or tissue-based (macrophages). HIV reservoirs are highly heterogeneous, making it difficult to identify a specific biomarker or cell profile for a given reservoir. A distinctive feature of HIV reservoirs may be the selective interaction between reservoir cells and platelets. The presence of HIV in platelets could impact disease progression, particularly by triggering the reversal of HIV latency and leading to residual viral production. The frequency of platelets containing circulating virus in the blood is approximately 0.1% of the total platelet volume. Although seemingly negligible, this would represent a daily input of 10⁸ platelets harboring the virus. Furthermore, patients whose platelets contain HIV are primarily those with persistent immunological failure, known as "immunological non-responders" (InR). The regulation of the size (number and frequency) of the HIV reservoir by platelets is not known. However, HIV-containing platelets form more conjugates with CD4+ T cells than HIV-free platelets. While HIV-containing platelets do not productively infect cells, they induce metabolic dysfunction in CD4+ T cells (aerobic glycolysis). Increased aerobic glycolysis is a hallmark of T cell activation and senescence. This suggests an interconnection between the presence of the virus in platelets, the size of the reservoir, and immune dysfunction in HIV.
Metabolic Liver Disease in Newly Diagnosed People Living With HIV (MASHIV-TR)
This study aims to identify the risk factors that lead to the development of metabolic liver disease in people who have been newly diagnosed with HIV. The research will take place across 9 centers in Türkiye and plans to include 250 newly diagnosed individuals with HIV, alongside 161 healthy individuals without HIV as a control group. Participants will have their liver health checked when they first join the study (baseline) and then once a year for up to 5 years (at 12, 24, 36, 48, and 60 months). The main goal of these visits is to monitor their metabolic health and understand who is at risk of developing a fatty liver condition known as MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease). During each visit, the research team will collect information about the participants' general health, including their height, weight, medical and family history, lifestyle habits, and sleep patterns. They will also record any medications being taken, including HIV treatments. To thoroughly check liver health, researchers will use routine blood tests (measuring things like cholesterol, blood sugar, and kidney function) and painless, non-invasive imaging tests, such as ultrasounds and FibroScans, to measure liver fat and stiffness.
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