Re-examining the HIV ‘functional cure’ oxymoron: Time for precise terminology?

Dubé, Karine; Loreen, Willenberg; Dee, Lynda; Sylla, Laurie; Taylor, Jeff; Roebuck, Christopher; Palm, David; Campbell, Danielle; Newton, Luke; Patel, Hursch; Perry, Kelly E.; Kanazawa, John; Gerrard, Jo; Brown, Brandon; Saberi, Parya; Sauceda, John A; Peluso, Michael J.

doi:10.1016/j.jve.2020.100017

Cited by 13 publications

(14 citation statements)

References 51 publications

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“…Involvement of PLHIV and key populations in HIV cure research is essential to ensure that their expectations, ideas, and opinions are considered in the design of possible future interventions aimed at achieving a cure. 14 , 18 , 47 , 48 , 49 Although our results showed similarities between the perceptions of the impact of cure scenarios among PLHIV and key populations, differences in perceptions may exist in other key populations, such as sex workers and should be addressed by further research. Finally, reliability of the data was enhanced by using the validated Braun and Clark checklist and the COREQ.…”

Section: Discussionmentioning

confidence: 61%

“…Understanding how a cure might affect the lives of these population groups is key for its successful implementation. 17 , 18 …”

Section: Introductionmentioning

confidence: 99%

“…The second scenario involves complete elimination of HIV from the body. 18 , 19 This cure scenario does not result in immunity to the virus, and cured individuals could hypothetically become re-infected with HIV in future.…”

Section: Introductionmentioning

confidence: 99%

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The perceived impact of an HIV cure by people living with HIV and key populations vulnerable to HIV in the Netherlands: A qualitative study

Romijnders

Groot

Vervoort

et al. 2022

Journal of Virus Eradication

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Section: Discussionmentioning

confidence: 61%

“…Understanding how a cure might affect the lives of these population groups is key for its successful implementation. 17 , 18 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The perceived impact of an HIV cure by people living with HIV and key populations vulnerable to HIV in the Netherlands: A qualitative study

Romijnders

Groot

Vervoort

et al. 2022

Journal of Virus Eradication

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“…Language : There is a substantial literature on the proper use of language to describe HIV cure research, and those who participate in it [ 126 – 132 ]. Although not specific to HIV cure research, PLWH have advocated for the use of “people-first” language, such as “people living with HIV” rather than “HIV-infected individuals,” and for the use of the word “participants” or “volunteers” rather than “subjects” to describe those actively participating in research [ 133 – 135 ].…”

Section: Discussionmentioning

confidence: 99%

Ethics of HIV cure research: an unfinished agenda

et al. 2021

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Background The pursuit of a cure for HIV is a high priority for researchers, funding agencies, governments and people living with HIV (PLWH). To date, over 250 biomedical studies worldwide are or have been related to discovering a safe, effective, and scalable HIV cure, most of which are early translational research and experimental medicine. As HIV cure research increases, it is critical to identify and address the ethical challenges posed by this research. Methods We conducted a scoping review of the growing HIV cure research ethics literature, focusing on articles published in English peer-reviewed journals from 2013 to 2021. We extracted and summarized key developments in the ethics of HIV cure research. Twelve community advocates actively engaged in HIV cure research provided input on this summary and suggested areas warranting further ethical inquiry and foresight via email exchange and video conferencing. Discussion Despite substantial scholarship related to the ethics of HIV cure research, additional attention should focus on emerging issues in six categories of ethical issues: (1) social value (ongoing and emerging biomedical research and scalability considerations); (2) scientific validity (study design issues, such as the use of analytical treatment interruptions and placebos); (3) fair selection of participants (equity and justice considerations); (4) favorable benefit/risk balance (early phase research, benefit-risk balance, risk perception, psychological risks, and pediatric research); (5) informed consent (attention to language, decision-making, informed consent processes and scientific uncertainty); and (6) respect for enrolled participants and community (perspectives of people living with HIV and affected communities and representation). Conclusion HIV cure research ethics has an unfinished agenda. Scientific research and bioethics should work in tandem to advance ethical HIV cure research. Because the science of HIV cure research will continue to rapidly advance, ethical considerations of the major themes we identified will need to be revisited and refined over time.

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“…Although the expression of "functional cure" is contradictory and inconsistently employed across a wide array of research initiatives aimed at curing HIV, it has been used most frequently to refer to long-term ART-free HIV control, meaning restoring the immune system's ability to combat infection (5). The "Berlin Patient" (6) and the "London Patient" (7) are two examples of patients that have been functionally cured of HIV.…”

Section: Introductionmentioning

confidence: 99%

Knowledge From London and Berlin: Finding Threads to a Functional HIV Cure

2021

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Despite the ability of combination antiretroviral therapy (cART) to increase the life expectancy of patients infected with human immunodeficiency virus (HIV), viral reservoirs persist during life-long treatment. Notably, two cases of functional cure for HIV have been reported and are known as the “Berlin Patient” and the “London Patient”. Both patients received allogeneic hematopoietic stem cell transplantation from donors with homozygous CCR5 delta32 mutation for an associated hematological malignancy. Therefore, there is growing interest in creating an HIV-resistant immune system through the use of gene-modified autologous hematopoietic stem cells with non-functional CCR5. Moreover, studies in CXCR4-targeted gene therapy for HIV have also shown great promise. Developing a cure for HIV infection remains a high priority. In this review, we discuss the increasing progress of coreceptor-based hematopoietic stem cell gene therapy, cART, milder conditioning regimens, and shock and kill strategies that have important implications for designing potential strategies aiming to achieve a functional cure for the majority of people with HIV.

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Re-examining the HIV ‘functional cure’ oxymoron: Time for precise terminology?

Cited by 13 publications

References 51 publications

The perceived impact of an HIV cure by people living with HIV and key populations vulnerable to HIV in the Netherlands: A qualitative study

The perceived impact of an HIV cure by people living with HIV and key populations vulnerable to HIV in the Netherlands: A qualitative study

Ethics of HIV cure research: an unfinished agenda

Knowledge From London and Berlin: Finding Threads to a Functional HIV Cure

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