UMMS Affiliation

School of Medicine

Publication Date

2018-07-01

Document Type

Article

Disciplines

Health Services Administration | Immunoprophylaxis and Therapy | International Public Health | Therapeutics | Virus Diseases

Abstract

Thinking about public health impact should inform HIV curative investigations. Should an effective HIV cure or sustained viral remission intervention emerge from ongoing investigations, implementation strategies aimed at ensuring global access will be needed if these approaches are to be impactful, and planning accordingly makes sense now. Specifically, we discuss three key access barriers to future cure-related interventions: high cost of the strategy; non-financial challenges to procurement, distribution and point-of-care delivery; and non-adherence and the need for long-term monitoring. As we argue, plans and decision-making for overcoming each of these barriers will need to be developed in advance. An evaluation of remaining barriers and likely global impact of the leading strategies under investigation should inform decisions on which strategy might receive funding priority. Among the strategies being investigated, implementation barriers for latency-reversing agents, immunotherapy and combination antiretroviral therapy (ART) may be overcome on a global scale with some effort. Overcoming implementation barriers for medically complex and high-risk interventions, such as stem cell and, to some degree, gene therapy, may be less feasible.

Keywords

HIV, cure, remission induction, genetic therapy, stem cell transplantation, immunotherapy, health plan implementation

Rights and Permissions

© 2018 The Authors. Journal of Virus Eradication published by Mediscript Ltd. This is an open access article published under the terms of a Creative Commons License.

Source

J Virus Erad. 2018 Jul 1;4(3):182-185. Link to article on publisher's site

Journal/Book/Conference Title

Journal of virus eradication

Related Resources

Link to Article in PubMed

PubMed ID

30050682

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