From antiretrovirals to curative therapies: Current developments in HIV treatment and prevention

Human immunodeficiency virus (HIV) is a major global health challenge. Antiretroviral therapy (ART) provides effective viral suppression but falls short of achieving a definitive cure. Lifelong ART is further complicated by drug-related toxicities, adherence barriers and the persistence of latent viral reservoirs. In recent years, innovative therapeutic strategies have emerged to address these limitations. Gene-based approaches, including CRISPR/Cas9 editing, stem cell transplantation, and latency-reversing or latency-silencing strategies are being explored to directly target and eliminate viral reservoirs. Parallel efforts in immunotherapy, therapeutic and preventive vaccines, pre-exposure prophylaxis (PrEP), and treatment as prevention (TasP) are expanding the preventive and therapeutic strategies. This review summarizes the evolution of HIV therapies, highlights recent advances across these diverse approaches and discusses their potential to reshape future management. We also outline current challenges and research priorities, particularly regarding reservoir eradication, safe and scalable delivery platforms, and ensuring accessibility in resource-limited settings. These innovations together offer promising avenues toward functional cure strategies and contribute to the global effort to end the HIV epidemic by 2030.