Resumen
El VIH ha sido un virus que lleva muchos años en investigación, aun así, su eliminación total, sigue siendo un gran desafío. Esta revisión bibliográfica analiza los avances, retos, perspectivas en enfoques terapéuticos y las vivencias de grupos vulnerable en la búsqueda de una cura para el VIH, centrándose en terapias, como los anticuerpos monoclonales y la terapia con células CAR-T. A su vez, se discuten los obstáculos que dificultan el desarrollo de una cura, tales como la diversidad genética del virus, la formación de reservorios virales latentes. Sin embargo, la falta de resistencia a los tratamientos ha demostrado ser el factor más relevante, por cual es importante una intervención temprana por parte del personal de la salud. Además, se examinan las barreras sociales y económicas que impiden el acceso de los pacientes a la atención médica y la adherencia al tratamiento, como la discriminación y el estigma. Destacando la importancia de un diagnóstico temprano, con el fin de, mejorar la adherencia al tratamiento y reducir los costos que conlleva esta enfermedad, tanto a corto como a largo plazo.
Citas
1. Canape J, Diallo MA, Soudeyns H. Nature and evolution of the cellular HIV-1 reservoir in children and adolescents. Virologie. 2023;27(5):269–283.
2. Lee PH, Keller MD, Hanley PJ, Bollard CM. Virus-Specific T Cell Therapies for HIV: Lessons Learned From Hematopoietic Stem Cell Transplantation. Front Cell Infect Microbiol. 2020;10(July):1–10.
3. Notario C. Adherencia al tratamiento antirretroviral en pacientes VIH. Rev Multidiscip Del Sida [Internet]. 2022;10:7-3. Available from: file:///C:/Users/pc/Downloads/Adherencia al tratamiento antirretroviral en pacientes vih - CLARA NOTARIO.pdf
4. Turk G, Laufer N. Cura del VIH: ¿qué tan lejos estamos? Actual en Sida e Infectología. 2023;31(1):7–10.
5. de Oliveira KH. ‘Transplanting Hope’: Experimental Stem Cell Therapy and the Political Economy of an HIV Cure. Vibrant Virtual Brazilian Anthropol. 2024;21:1–24.
6. Elizalde-Barrera CI, Juárez-Mendoza C V., Maliachi-Díaz A, Rosado-Arenas IA, Sandoval-Ocampo S, Tinoco-Montes LE. Prevalence of impaired fasting glucose and dyslipidemia among Mexican HIV antiretroviral-naïve patients. Cir y Cir (English Ed. 2023;91(1):100–106.
7. González C, Lissette A, Alvarado C, Madelaine A, Pincay S, Nicole K. Virus de la Inmunodeficiencia Humana (VIH) efectos y complicaciones adquiridas durante la infección Human Immunodeficiency Virus (HIV) effects and complications acquired during infection. Julio-Diciembre [Internet]. 2022;7(2):2022–34. Available from: https://orcid.org/0000-0003-2416-4942
8. Pérez J. Adherencia al tratamiento antirretroviral de personas con VIH/sida en la Atención Primaria de Salud. Rev Habanera Ciencias Médicas [Internet]. 2020;19(5):1–11. Available from: http://www.revhabanera.sld.cu/index.php/rhab/article/view/2962
9. Zapata-Pizarro A, Muena-Bugueño C, Quiroz-Nilo S, Serri-Venegas M, Usedo-López P. Consideraciones en población transgénero respecto a la infección por VIH, terapia antiretroviral, profilaxis preexposición (PreP) e interacción con tratamiento de reafirmación de género. Rev Chil infectología. 2022;39(2):149–156.
10. Ying R, Fekadu L, Schackman BR, Verguet S. Spatial distribution and characteristics of HIV clusters in Ethiopia. Trop Med Int Heal. 2020;25(3):301–307.
11. extensions @ www.prisma-statement.org [Internet]. Available from: https://www.prisma-statement.org/extensions
12. Pitasi MA, Beer L, Cha S, Lyons SJ, Hernandez AL, Prejean J, et al. Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex with Men — United States, 2010–2019 . MMWR Morb Mortal Wkly Rep. 2021;70(48):1669–1675.
13. Liu W Da, Tsai WC, Hsu WT, Shih MC, Chen MY, Sun HY, et al. Impact of initiation of combination antiretroviral therapy according to the WHO recommendations on the survival of HIV-positive patients in Taiwan. J Microbiol Immunol Infect [Internet]. 2020;53(6):936–945. Available from: https://doi.org/10.1016/j.jmii.2019.03.008
14. Moranguinho I, Taveira N, Bártolo I. Antiretroviral Treatment of HIV-2 Infection: Available Drugs, Resistance Pathways, and Promising New Compounds. Int J Mol Sci. 2023;24(6):1-19.
15. Grassi G, Notari S, Cicalini S, Casetti R, Cimini E, Bordoni V, et al. Brief Report: In cART-Treated HIV-Infected Patients, Immunologic Failure Is Associated with a High Myeloid-Derived Suppressor Cell Frequency. J Acquir Immune Defic Syndr. 2024;95(2):185–189.
16. Bareng OT, Moyo S, Zahralban-Steele M, Maruapula D, Ditlhako T, Mokaleng B, et al. HIV-1 drug resistance mutations among individuals with low-level viraemia while taking combination ART in Botswana. J Antimicrob Chemother. 2022;77(5):1385–1395.
17. Ross J, Jiamsakul A, Kumarasamy N, Azwa I, Merati TP, Do CD, et al. Virological failure and HIV drug resistance among adults living with HIV on second-line antiretroviral therapy in the Asia-Pacific. HIV Med. 2021;22(3):201–211.
18. Cholette F, Lazarus L, Macharia P, Walimbwa J, Kuria S, Bhattacharjee P, et al. HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya. BMC Infect Dis [Internet]. 2024;24(1). Available from: https://doi.org/10.1186/s12879-024-10052-5
19. Van der Merwe LLA, Moyo I, Mavhandu-Mudzusi AH. Determinants of antiretroviral therapy adherence among transgender women in South Africa. South African Fam Pract. 2024;66(1):1–8.
20. Azia IN, Nyembezi A. Beliefs of Pentecostal pastors on the use of antiretroviral treatment among Pentecostal Christians living with HIV in a suburb of Cape Town-South Africa : a community health systems lens. 2025;40(1):13–22. Available from: https://doi.org/https://doi.org/10.1093/heapol/czae089
21. Saxena V, Xu A, Kinley K, Tsheten T, Gyeltshen T, Tobgay T, et al. Stigma and discrimination against transgender men in Bhutan. PLoS One [Internet]. 2023;18(7 JULY):1–11. Available from: http://dx.doi.org/10.1371/journal.pone.0287745
22. Nguyen NT, Nguyen T, Vu G Van, Truong N, Pham Y, Guevara Alvarez G, et al. Depression and associated factors among HIV-positive smokers receiving care at HIV outpatient clinics in Vietnam: A cross-sectional analysis. BMJ Open. 2024;14(2):1–8.
23. Freire IM, de Souza Minayo MC. Trajectories of adolescents living with vertical transmission-HIV virus. Cienc e Saude Coletiva. 2024;29(8).
24. Tozan Y, Capasso A, Sun S, Neilands TB, Damulira C, Namuwonge F, et al. The efficacy and cost-effectiveness of a family-based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV: results from a Cluster Randomized Controlled Trial in southern Uganda. J Int AIDS Soc. 2021;24(6):1–7.
25. Patricia Cavazos-Rehg, Christine Xu, Erin Kasson, William Byansi, Ozge Sensoy Bahar FMS. Social and Economic Equity and Family Cohesion as Potential Protective Factors from Depression Among Adolescents Living with HIV in Uganda. Dep Salud y Serv Humanos los Estados Unidos [Internet]. 2020;24(9):2546–2554. Available from: https://pubmed.ncbi.nlm.nih.gov/32095914/
26. Angelo AT, Alemayehu DS. Adherence and its associated factors among adult hiv-infected patients on antiretroviral therapy in South Western Ethiopia, 2020. Patient Prefer Adherence. 2021;15:299–308.
27. Olashore AA, Paruk S, Ogunwale A, Ita M, Tomita A, Chiliza B. The effectiveness of psychoeducation and problem-solving on depression and treatment adherence in adolescents living with HIV in Botswana: an exploratory clinical trial. Child Adolesc Psychiatry Ment Health [Internet]. 2023;17(1):1–10. Available from: https://doi.org/10.1186/s13034-022-00541-3
28. Attal BA, Al-Rowaishan KM, Akeel AA, AlAmmar FK. HIV stigma in the teaching hospitals in Sana’a, Yemen: a conflict and low-resource setting. BMC Public Health. 2021;21(1):1–10.
29. Sekabira R, McGowan I, Yuhas K, Brand RM, Marzinke MA, Manabe YC, et al. Higher colorectal tissue HIV infectivity in cisgender women compared with MSM before and during oral preexposure prophylaxis. Aids. 2021;35(10):1585–1595.
30. Godfrey C, Hughes MD, Ritz J, Coelho L, Gross R, Salata R, et al. PRESENTING FOR THIRD-LINE ANTIRETROVIRAL THERAPY. 2021;84(2):203–207.
31. Ward MK, Fernandez SB, Sheehan DM, Li T, Dawit R, Fennie K, et al. Sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression in the Miami-Dade County Ryan White Program, 2017. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2023;35(10):1437–1442.
32. Báez P, Tiburcio A, Alba N, Mateo F, Grullon E, Cordero S, et al. Medición de adherencia a antirretrovirales con métodos múltiples en La Romana, República Dominicana. Rev Panam Salud Pública. 2022;46:1-9.
33. Ahmed I, Demissie M, Worku A, Gugsa S, Berhane Y. Adherence to antiretroviral treatment among people who started treatment on the same-day of hiv diagnosis in ethiopia: A multicenter observational study. HIV/AIDS - Res Palliat Care. 2021;13:983–991.
34. Rosen JG, Ddaaki WG, Nakyanjo N, Chang LW, Vo A Van, Zhao T, et al. The potential promise and pitfalls of point-of-care viral load monitoring to expedite HIV treatment decision-making in rural Uganda: a qualitative study. BMC Health Serv Res. 2024;24(1):1265.
35. Zaniewski E, Skrivankova VW, Brazier E, Avihingsanon A, Cardoso SW, Cesar C, et al. Transition to dolutegravir-based ART in 35 low-and middle-income countries: A global survey of HIV care clinics. Aids. 2024;38(15):2073-2085.
36. Reshadat-Hajiabad T, Khajavi A, Hosseinpour AM, Bojdy A, Hashemi-Meshkini A, Varmaghani M. Determinants and economic burden of HIV/AIDS in Iran: a prospective study. BMC Health Serv Res. 2023;23(1):1–8.
37. Boomer KB. Special Issue: Examining the Impacts of Social Determinants on HIV Health and Prevention. Int J Environ Res Public Health. 2024;21(30).
38. Dean LT, Nonyane BAS, Ugoji C, Visvanathan K, Jacobson LP, Lau B. Economic Burden among Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV or Living Without HIV in the Multicenter AIDS Cohort Study. J Acquir Immune Defic Syndr. 2020;85(4):436–443.
39. Crawford ND, Harrington KRV, Chandra C, Alohan DI, Quamina A, Beck O, et al. Feasibility of reaching populations at high risk for HIV in community pharmacies. J Am Pharm Assoc. 2024 Nov 1;64(6):102239.
40. Rotheram MJ, Fernandez MI, Lee SJ, Abdalian SE, Kozina L, Koussa M, et al. Strategies to treat and prevent hiv in the united states for adolescents and young adults: Protocol for a mixed-methods study. JMIR Res Protoc. 2019;8(1):1–14.
2. Lee PH, Keller MD, Hanley PJ, Bollard CM. Virus-Specific T Cell Therapies for HIV: Lessons Learned From Hematopoietic Stem Cell Transplantation. Front Cell Infect Microbiol. 2020;10(July):1–10.
3. Notario C. Adherencia al tratamiento antirretroviral en pacientes VIH. Rev Multidiscip Del Sida [Internet]. 2022;10:7-3. Available from: file:///C:/Users/pc/Downloads/Adherencia al tratamiento antirretroviral en pacientes vih - CLARA NOTARIO.pdf
4. Turk G, Laufer N. Cura del VIH: ¿qué tan lejos estamos? Actual en Sida e Infectología. 2023;31(1):7–10.
5. de Oliveira KH. ‘Transplanting Hope’: Experimental Stem Cell Therapy and the Political Economy of an HIV Cure. Vibrant Virtual Brazilian Anthropol. 2024;21:1–24.
6. Elizalde-Barrera CI, Juárez-Mendoza C V., Maliachi-Díaz A, Rosado-Arenas IA, Sandoval-Ocampo S, Tinoco-Montes LE. Prevalence of impaired fasting glucose and dyslipidemia among Mexican HIV antiretroviral-naïve patients. Cir y Cir (English Ed. 2023;91(1):100–106.
7. González C, Lissette A, Alvarado C, Madelaine A, Pincay S, Nicole K. Virus de la Inmunodeficiencia Humana (VIH) efectos y complicaciones adquiridas durante la infección Human Immunodeficiency Virus (HIV) effects and complications acquired during infection. Julio-Diciembre [Internet]. 2022;7(2):2022–34. Available from: https://orcid.org/0000-0003-2416-4942
8. Pérez J. Adherencia al tratamiento antirretroviral de personas con VIH/sida en la Atención Primaria de Salud. Rev Habanera Ciencias Médicas [Internet]. 2020;19(5):1–11. Available from: http://www.revhabanera.sld.cu/index.php/rhab/article/view/2962
9. Zapata-Pizarro A, Muena-Bugueño C, Quiroz-Nilo S, Serri-Venegas M, Usedo-López P. Consideraciones en población transgénero respecto a la infección por VIH, terapia antiretroviral, profilaxis preexposición (PreP) e interacción con tratamiento de reafirmación de género. Rev Chil infectología. 2022;39(2):149–156.
10. Ying R, Fekadu L, Schackman BR, Verguet S. Spatial distribution and characteristics of HIV clusters in Ethiopia. Trop Med Int Heal. 2020;25(3):301–307.
11. extensions @ www.prisma-statement.org [Internet]. Available from: https://www.prisma-statement.org/extensions
12. Pitasi MA, Beer L, Cha S, Lyons SJ, Hernandez AL, Prejean J, et al. Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex with Men — United States, 2010–2019 . MMWR Morb Mortal Wkly Rep. 2021;70(48):1669–1675.
13. Liu W Da, Tsai WC, Hsu WT, Shih MC, Chen MY, Sun HY, et al. Impact of initiation of combination antiretroviral therapy according to the WHO recommendations on the survival of HIV-positive patients in Taiwan. J Microbiol Immunol Infect [Internet]. 2020;53(6):936–945. Available from: https://doi.org/10.1016/j.jmii.2019.03.008
14. Moranguinho I, Taveira N, Bártolo I. Antiretroviral Treatment of HIV-2 Infection: Available Drugs, Resistance Pathways, and Promising New Compounds. Int J Mol Sci. 2023;24(6):1-19.
15. Grassi G, Notari S, Cicalini S, Casetti R, Cimini E, Bordoni V, et al. Brief Report: In cART-Treated HIV-Infected Patients, Immunologic Failure Is Associated with a High Myeloid-Derived Suppressor Cell Frequency. J Acquir Immune Defic Syndr. 2024;95(2):185–189.
16. Bareng OT, Moyo S, Zahralban-Steele M, Maruapula D, Ditlhako T, Mokaleng B, et al. HIV-1 drug resistance mutations among individuals with low-level viraemia while taking combination ART in Botswana. J Antimicrob Chemother. 2022;77(5):1385–1395.
17. Ross J, Jiamsakul A, Kumarasamy N, Azwa I, Merati TP, Do CD, et al. Virological failure and HIV drug resistance among adults living with HIV on second-line antiretroviral therapy in the Asia-Pacific. HIV Med. 2021;22(3):201–211.
18. Cholette F, Lazarus L, Macharia P, Walimbwa J, Kuria S, Bhattacharjee P, et al. HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya. BMC Infect Dis [Internet]. 2024;24(1). Available from: https://doi.org/10.1186/s12879-024-10052-5
19. Van der Merwe LLA, Moyo I, Mavhandu-Mudzusi AH. Determinants of antiretroviral therapy adherence among transgender women in South Africa. South African Fam Pract. 2024;66(1):1–8.
20. Azia IN, Nyembezi A. Beliefs of Pentecostal pastors on the use of antiretroviral treatment among Pentecostal Christians living with HIV in a suburb of Cape Town-South Africa : a community health systems lens. 2025;40(1):13–22. Available from: https://doi.org/https://doi.org/10.1093/heapol/czae089
21. Saxena V, Xu A, Kinley K, Tsheten T, Gyeltshen T, Tobgay T, et al. Stigma and discrimination against transgender men in Bhutan. PLoS One [Internet]. 2023;18(7 JULY):1–11. Available from: http://dx.doi.org/10.1371/journal.pone.0287745
22. Nguyen NT, Nguyen T, Vu G Van, Truong N, Pham Y, Guevara Alvarez G, et al. Depression and associated factors among HIV-positive smokers receiving care at HIV outpatient clinics in Vietnam: A cross-sectional analysis. BMJ Open. 2024;14(2):1–8.
23. Freire IM, de Souza Minayo MC. Trajectories of adolescents living with vertical transmission-HIV virus. Cienc e Saude Coletiva. 2024;29(8).
24. Tozan Y, Capasso A, Sun S, Neilands TB, Damulira C, Namuwonge F, et al. The efficacy and cost-effectiveness of a family-based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV: results from a Cluster Randomized Controlled Trial in southern Uganda. J Int AIDS Soc. 2021;24(6):1–7.
25. Patricia Cavazos-Rehg, Christine Xu, Erin Kasson, William Byansi, Ozge Sensoy Bahar FMS. Social and Economic Equity and Family Cohesion as Potential Protective Factors from Depression Among Adolescents Living with HIV in Uganda. Dep Salud y Serv Humanos los Estados Unidos [Internet]. 2020;24(9):2546–2554. Available from: https://pubmed.ncbi.nlm.nih.gov/32095914/
26. Angelo AT, Alemayehu DS. Adherence and its associated factors among adult hiv-infected patients on antiretroviral therapy in South Western Ethiopia, 2020. Patient Prefer Adherence. 2021;15:299–308.
27. Olashore AA, Paruk S, Ogunwale A, Ita M, Tomita A, Chiliza B. The effectiveness of psychoeducation and problem-solving on depression and treatment adherence in adolescents living with HIV in Botswana: an exploratory clinical trial. Child Adolesc Psychiatry Ment Health [Internet]. 2023;17(1):1–10. Available from: https://doi.org/10.1186/s13034-022-00541-3
28. Attal BA, Al-Rowaishan KM, Akeel AA, AlAmmar FK. HIV stigma in the teaching hospitals in Sana’a, Yemen: a conflict and low-resource setting. BMC Public Health. 2021;21(1):1–10.
29. Sekabira R, McGowan I, Yuhas K, Brand RM, Marzinke MA, Manabe YC, et al. Higher colorectal tissue HIV infectivity in cisgender women compared with MSM before and during oral preexposure prophylaxis. Aids. 2021;35(10):1585–1595.
30. Godfrey C, Hughes MD, Ritz J, Coelho L, Gross R, Salata R, et al. PRESENTING FOR THIRD-LINE ANTIRETROVIRAL THERAPY. 2021;84(2):203–207.
31. Ward MK, Fernandez SB, Sheehan DM, Li T, Dawit R, Fennie K, et al. Sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression in the Miami-Dade County Ryan White Program, 2017. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2023;35(10):1437–1442.
32. Báez P, Tiburcio A, Alba N, Mateo F, Grullon E, Cordero S, et al. Medición de adherencia a antirretrovirales con métodos múltiples en La Romana, República Dominicana. Rev Panam Salud Pública. 2022;46:1-9.
33. Ahmed I, Demissie M, Worku A, Gugsa S, Berhane Y. Adherence to antiretroviral treatment among people who started treatment on the same-day of hiv diagnosis in ethiopia: A multicenter observational study. HIV/AIDS - Res Palliat Care. 2021;13:983–991.
34. Rosen JG, Ddaaki WG, Nakyanjo N, Chang LW, Vo A Van, Zhao T, et al. The potential promise and pitfalls of point-of-care viral load monitoring to expedite HIV treatment decision-making in rural Uganda: a qualitative study. BMC Health Serv Res. 2024;24(1):1265.
35. Zaniewski E, Skrivankova VW, Brazier E, Avihingsanon A, Cardoso SW, Cesar C, et al. Transition to dolutegravir-based ART in 35 low-and middle-income countries: A global survey of HIV care clinics. Aids. 2024;38(15):2073-2085.
36. Reshadat-Hajiabad T, Khajavi A, Hosseinpour AM, Bojdy A, Hashemi-Meshkini A, Varmaghani M. Determinants and economic burden of HIV/AIDS in Iran: a prospective study. BMC Health Serv Res. 2023;23(1):1–8.
37. Boomer KB. Special Issue: Examining the Impacts of Social Determinants on HIV Health and Prevention. Int J Environ Res Public Health. 2024;21(30).
38. Dean LT, Nonyane BAS, Ugoji C, Visvanathan K, Jacobson LP, Lau B. Economic Burden among Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV or Living Without HIV in the Multicenter AIDS Cohort Study. J Acquir Immune Defic Syndr. 2020;85(4):436–443.
39. Crawford ND, Harrington KRV, Chandra C, Alohan DI, Quamina A, Beck O, et al. Feasibility of reaching populations at high risk for HIV in community pharmacies. J Am Pharm Assoc. 2024 Nov 1;64(6):102239.
40. Rotheram MJ, Fernandez MI, Lee SJ, Abdalian SE, Kozina L, Koussa M, et al. Strategies to treat and prevent hiv in the united states for adolescents and young adults: Protocol for a mixed-methods study. JMIR Res Protoc. 2019;8(1):1–14.
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Derechos de autor 2025 Carlos Martínez-Santander , Heidy Mabel Guzman Salinas, Génesis Damaris Heredia-Paguay, Angélica Ortega- Zárate.
Descargas
Los datos de descargas todavía no están disponibles.