HIV/AIDS Awareness Month

Overview

HIV (human immunodeficiency virus) is a retrovirus that targets CD4+ T cells, which are a key part of the immune system. Untreated, it progresses to AIDS with life-threatening opportunistic infections and cancers. Here's something that still feels wild to say: with modern antiretroviral therapy (ART), HIV is now a chronic, manageable condition, and people on effective treatment with undetectable viral loads do not transmit the virus sexually.

Impact

Millions of people worldwide live with HIV. The heaviest burden is in sub-Saharan Africa, and in the US there are persistent disparities affecting Black and Hispanic communities, men who have sex with men, and transgender women. Even with huge medical progress, stigma, criminalization, and unequal access to prevention and care keep limiting progress toward ending the epidemic, and they also feed into mental health burden, housing insecurity, and delayed diagnosis.

Medical Overview

Diagnosis uses fourth- and fifth-generation antigen/antibody tests followed by confirmatory testing, and acute HIV can be detected within weeks of exposure. Current ART regimens (usually built around an integrase strand transfer inhibitor) are highly effective, well tolerated, and available as daily oral pills or long-acting injectables. Preexposure prophylaxis (PrEP) with oral tenofovir-based regimens or long-acting cabotegravir cuts transmission substantially, and the newer capsid inhibitor lenacapavir expands options for heavily treatment-experienced patients and for prevention. Full-picture care covers viral suppression, prevention of opportunistic infections, cardiovascular and metabolic risk, coinfections (hepatitis B and C, TB, syphilis), oral health, and mental health. Research toward a cure is actively looking at latent viral reservoirs, broadly neutralizing antibodies, therapeutic vaccines, and gene-based approaches.

References

1. Alum EU, Uti DE, Ugwu OP, Alum BN. Toward a cure - Advancing HIV/AIDS treatment modalities beyond antiretroviral therapy: A Review . Medicine (Baltimore) . 2024.
2. Dvory-Sobol H, Shaik N, Callebaut C, Rhee MS. Lenacapavir: a first-in-class HIV-1 capsid inhibitor . Current Opinion in HIV and AIDS . 2022.
3. van Heuvel Y, Schatz S, Rosengarten JF, Stitz J. Infectious RNA: Human Immunodeficiency Virus (HIV) Biology, Therapeutic Intervention, and the Quest for a Vaccine . Toxins . 2022.