Efficacy of CRISPR-Cas9 Gene Editing Versus Latency Reversing Agents for HIV Proviral Elimination in ART-Suppressed Patients: A Review
Kabazzi Douglas T.
Department of Pharmaceutics Kampala International University Uganda
Email: t.kabazzi@studwc.kiu.ac.ug
ABSTRACT
Despite sustained viral suppression achieved through antiretroviral therapy (ART), HIV persists in latently infected cells, forming proviral reservoirs that remain the principal barrier to cure. Latency reversing agents (LRAs) and CRISPR-Cas9 gene editing are the two innovative approaches that have emerged as leading strategies for targeting and eliminating these reservoirs in ART-suppressed individuals. While LRAs aimed to reactivate latent proviruses for immune-mediated clearance, CRISPR-Cas9 seeks to excise or inactivate integrated viral DNA through sequence-specific genome editing. This review aimed to critically compare the efficacy, mechanisms, clinical readiness, and safety profiles of these two approaches in the context of HIV proviral elimination. A narrative review methodology was employed to synthesize peer-reviewed findings from preclinical and clinical studies published between 2010 and 2025. Findings revealed that LRAs consistently induced HIV transcription but failed to significantly reduce reservoir size due to limited immune clearance, whereas CRISPR-Cas9 demonstrated more definitive proviral disruption in preclinical models but is constrained by delivery challenges and the risk of viral escape or off-target effects. Both strategies hold promise, neither is sufficient alone; combination therapies, improved delivery systems, and individualized viral targeting may be necessary to achieve durable remission or eradication. Future research should prioritize integrated cure strategies combining molecular precision with immune enhancement.
Keywords: HIV cure strategies, CRISPR-Cas9 gene editing, Latency reversing agents, Proviral elimination, ART-suppressed individuals.
CITE AS: Kabazzi Douglas T. (2025). Efficacy of CRISPR-Cas9 Gene Editing Versus Latency Reversing Agents for HIV Proviral Elimination in ART-Suppressed Patients: A Review. IDOSR JOURNAL OF APPLIED SCIENCES 10(2):77-81, 2025. https://doi.org/10.59298/IDOSRJAS/2025/102.7781