Institutionalizing HIV-Cure advocacy, implementation and vigorous longitudinal research in African countries will not only popularize the science and trials uptake by subjects but help reproduce results such as the ‘Berlin Patient.’ Africa needs to use many strategies to bring down the escalating HIV Prevalence. From South Africa's bold anti-HIV innovations (http://www.sahivsoc.org/(1) to Uganda's robust treatment and prevention initiatives, Africa has all it takes to act as an HIV-Cure force (http://www.avert.org (2).
HIV persists in spite of potent ART through the establishment of HIV latency, when integrated viral DNA is silenced by host mechanisms and the virus cannot be accessed by current ART or by host clearance mechanisms. The primary cellular target for HIV infection is the CD4+T cell. Most infected cells die rapidly but a small proportion become stably infected with integrated HIV-originated DNA and revert to a long-lived resting phenotype . Additional barriers to HIV cure include the existence of non-T cell reservoirs, such as macrophages, ongoing cycles of HIV replication even in the presence of ART, persistent blood/tissue HIV-RNA and an immune system that is permanently affected by HIV that cannot adequately clear the virus . Eradication of HIV in Africa is still held back by resources and policy. HIV cure to grow in momentum needs the combined effort of scientists, governments, development partners, leaders, policy makers,civil society, traditional healers and health advocates. HIV-cure can be institutionalized by leveraging an enabling environment that will in turn galvanize pro HIV-cure funding, human resource, legislation and an enduring culture of efficacy, documentation, ethics and nurturing (EDEN) of research work. The terminology, biomedical interventions and health informatics need to be understood, applicable and agreed upon by academics, policy-makers, leaders, professionals and African traditional healers in the field. To get there, seven aspects will make HIV cure robust and these are:
(i) Build on existing HIV Prevention and Control Initiatives as iterate opportunities for Pro HIV-Cure Strategies in Africa
(ii) Character of Social Aspects of Pro HIV-Cure Strategies in Africa
(iii) Character of Political Aspects of Pro HIV-Cure Strategies in Africa
(iv) Character of Anthropological Aspects of Pro HIV-Cure Strategies in Africa
(v) Character of Clinical Aspects of Pro HIV-Cure Strategies
(vi) Character of Economical Aspects of Pro HIV-Cure Strategies
(vii) Outcomes and reproduction of HIV-Cure Strategies in Africa
Africa has the structures to produce large numbers of post-treatment controllers as well as move towards zero infection (saafrica.org (6). Prioritizing resources and embracing global health trends are two major strategies that will ensure this outcome.
1. http://www.sahivsoc.org. Retrieved on January 18th 2016.
2. http://www.avert.org/professionals/hiv-around-world/sub-saharan-africa. Retrieved on January 18th 2016.
3. Siliciano JD, Kajdas J, Finzi D et al. Long-term follow-up studies confirm the stability of the latent reservoir for HIV-1 in resting CD4+ T cells. Nat Med 2003; 9: 727–728.
4. Siliciano RF, Greene WC. HIV latency. Cold Spring Harb Perspect Med 2011; 1: a00709.
5. Buzon MJ, Sun H, Li C et al. HIV-1 persistence in CD4(+) T cells with stem cell-like properties. Nat Med 2014; 20: 139–142.
6. http://saafrica.org. Retrieved on January 18th 2016.