Dado Galdieri/The New York Times

October 19, 2022

A Review on the Retrovirus After 40 Years of Tackling the AIDS Epidemic

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Since the first U.S. reported case of human immunodeficiency virus in 1981, the scientific community has not wavered in its commitment to both extending the life expectancy and improving the quality of life of those affected by HIV. 

HIV is a virus that attacks the host immune system and spreads through contact with bodily fluids of an infected individual. Acquired immunodeficiency syndrome is the final stage of HIV infection.

There has been an uptick in major developments in the simplification of HIV prevention with the approval of promising drugs, such as Cabotegravir, which have produced significant results in HIV treatment and prevention. 

Early studies of viruses, specifically the Rous Sarcoma Virus, have allowed researchers to gain an understanding of the retrovirus and cell machinery of HIV, an AIDS-causing retrovirus. 

Initial research of the RSV began in 1911 when a woman brought one of her hens into a lab after it developed sarcoma, a tumor that arises in the bones and soft tissue. Upon pulverizing the sarcoma to form a filtrate containing no cells, and transplanting this filtrate into other hens, Rous observed that many other hens also developed tumors. 

The characteristics of the tumor were comparable to those of communicable diseases, which spread from person to person. The tumor’s infectivity indicated its classification as a virus and revealed that a cancerous tumor could be induced by infection because the tumor was transmitted by a virus, a noncellular agent. 

RSV later proved to be an important factor in studying cancer development because of its identification as a retrovirus, which are RNA viruses that insert a copy of their genome into a host cell.

This discovery led researchers to prevent viruses like HIV from compromising the health of the host.

“Having that understanding prior to the discovery of HIV obviously was important in speeding up the process of developing drugs that target and block different proteins of the virus itself,” Prof. Olivier Elemento, physiology and biophysics at Weill Cornell Medicine, said. 

Elemento published an article in March 2021 summarizing how Rous’s work demonstrated the necessity of basic research and understanding biological mechanisms in great detail.

Since then, recent developments in AIDS research have focused on the production of long-acting medications. This approach, which involves a combination of two drugs that are given by monthly injections into the muscle, simplifies HIV treatment by eliminating the need for daily pills.

CABENUVA, a prescription regimen that combines the antiretroviral medication, Cabotegravir and a reverse transcriptase inhibitor, Rilpivirine, is the first injectable, complete regimen for adults with HIV approved by the FDA in Jan. 2021.  More recently, in Feb. 2022, the FDA approved expanded access to CABENUVA, to be administered to adults living with HIV. However, the injection of Cabotegravir by itself for preventive purposes was only FDA approved in Dec. 2021.
The drug has been studied in part by Weill Cornell and looks to be more effective than the oral drugs currently being taken for preventive purposes by those who are at high risk of HIV diagnosis, including men who have sex with other men and injection drug users.