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Model-based evaluation of the impact of a potential HIV cure on HIV transmission dynamics

Year: 2025

Type: article

Abstract: Biomedical research and clinical trials for curative HIV interventions are advancing rapidly. Understanding the potential impact of an HIV cure on transmission dynamics is key for its successful implementation at the population level. Using a mathematical model calibrated to the HIV epidemic among men who have sex with men (MSM) in the Netherlands as a case study, we tested the common hypothesis that an effective cure will contribute to HIV control and help end the epidemic. Guided by the target product profile (TPP) for an HIV cure, we evaluated the impact of two cure scenarios: (i) HIV remission, which entails suppression of the virus in the absence of ongoing antiretroviral treatment (ART) but carries a risk of viral rebound, and (ii) HIV eradication, which aims for complete removal of the virus. We found that either sustained HIV remission (with no risk of rebound) or HIV eradication could consistently reduce cumulative HIV incidence among MSM in the Netherlands by up to 50% for optimum TPP within eight years, relative to the baseline scenario without a cure. In contrast, transient HIV remission with a risk of rebound may drastically increase cumulative HIV incidence and disrupt the progress made toward HIV control under the current standard of care and prevention. These findings underscore the importance of the characteristics of curative HIV interventions in maximizing their benefits for public health and highlight the need to align HIV cure research with public health objectives to end the HIV epidemic.

Source: Nature Communications

DOI: 10.1038/s41467-025-58657-x