AIDS is a manageable disease due to decades of research conducted on the human immunodeficiency virus (HIV). However, current HIV treatment can still come with adverse effects, medication regimens are often complicated, and treatment options can be limited for patients with preexisting conditions, such as liver or kidney problems.1

Furthermore, many treatment options consist of several medications that target different aspects of the virus' replication cycle. A medication regimen is currently necessary due to the rapid nature of ribonucleic acid (RNA) mutation in the HIV genetic code, which allows the virus to adapt and resist current HIV therapies. This rapid adaptation makes it necessary for patients to use several drugs at once, as it will increase the likelihood that the regimen will continue to work successfully.1

New research published April 24, 2020 in Science on the structure of HIV has revealed a promising novel drug target for treating HIV infection. The results of the study showed that the virus’ genetic code can be read 2 different ways, resulting in 2 different forms of the virus' RNA.1

The researchers’ area of focus on the HIV RNA genome was ‘highly conserved’ in scope in this study. The results of this focus found that a highly conserved treatment allowed the rate of mutation to be less than other places in the genome, said Ghazal Becker, BA, a coauthor of the paper and recent University of Maryland graduate, in a press release. Becker explained that this increases the likelihood of a drug that targets that specific region to be effective for a longer duration.1

It may also allow 1 drug to be enough to treat the virus, rather than patients needing several drugs in their medication regimen.1

“If you're targeting a conserved region, you can potentially come up with a treatment plan that uses only 1 drug,” said Aishwarya Iyer, a coauthor of the paper and current MD/PhD student at the University of Maryland School of Medicine, in a press release. “It might have fewer [adverse] effects and could offer more treatment options to people with different health conditions.”2

These results allow for a range of new research opportunities for HIV researchers to embark upon in the future.2

“We're very interested to see how other labs will interpret our results, expand upon them, and possibly find other applications for this type of RNA function,” said Joshua Brown, PhD, the lead author on the study, in a press release.2

These future expansions and applications in further research may result in new treatments, which could have a major impact on the treatment outcomes of patients with HIV.2

“Every time we get a new drug in HIV, we exponentially improve the chances of individuals finding a drug that works for them, where resistance is a little less likely,” said Hannah Carter, current M.D./Ph.D. student at University of Michigan and co-author on the study, in a press release. “Every time a new drug can get on the scene, that's a significant improvement for the lives of HIV patients.”2

The results of this research may also have effects beyond HIV and into other medical fields.2

“Some HIV research has laid the groundwork in how we understand coronaviruses,” Carter said. “All basic science in HIV ends up having a ripple effect throughout all of virology.”2

REFERENCES
  1. Brown JD, Kharytonchyk S, Chaudry I, et al. Structural basis for transcriptional start site control of HIV-1 RNA fate. Science. 2020; 368(6489):413-417. doi: 10.1126/science.aaz7959.
  2. Breakthrough discovery in HIV research opens path to new, better therapies [news release]. Eurekalert; April 23, 2020. eurekalert.org/pub_releases/2020-04/uomb-bdi042120.php. Accessed April 29, 2020.