Editorial: The Global Phenotypic Diversity of HIV-1: Implications for Pathogenesis, Vaccine, and Cure

Azam Bolhassani ^*

• Pasteur Institute of Iran (PII), Tehran, Iran

Despite the clinical success of antiretroviral therapy, there is no cure for HIV infection, yet. As reported, HIV vaccines in development are in early-stage clinical trials (Haynes et al., 2023).Indeed, the global and regional genetic diversity of HIV-1 (i.e., its high genetic mutation and recombination rates) are a main challenge for HIV vaccine development. Thus, investigating the distribution of HIV subtypes/ clades in different regions is essential.To date, several immunotherapy approaches were considered to activate the immune system (e.g., CD8 + T cells and NK cells) and eradicate latently HIV-infected cells (i.e., elimination of the HIV reservoir) including: a) reactivation of the latently HIV-infected cells using epigenetic modulators (Spivak and Planelles, 2016;Kien and Jonathan, 2024) or immunostimulators (e.g., toll-like receptor (TLR) agonists) (Martinsen et al., 2020;Rozman et al., 2023); b) combination of a potent latency reversal agent (e.g., Romidepsin) with an immune modulator (e.g., a therapeutic vaccine) (Mothe et al., 2020 andRosas-Umbert et al., 2020); and c) the use of chimeric antigen receptors (CARs) for directly killing HIV-infected cells (Hajduczki et al., 2020;Zhou et al., 2023). Thus, it is critical to determine which immunotherapy approaches have an important effect in elimination of latently HIV-infected cells.At present, some studies aim to develop preventive HIV vaccines and also overcome antiretroviral drug resistance as a cure for HIV infection. Current approaches in the management of HIV infection include prevention/ reversion of viral latency, modulation of immune responses, development of novel vaccines, and improvement of antiretroviral drugs in HIV patients (Deeks et al., 2021;Maciel et al., 2024).To address these critical areas in HIV management, this research topic/ special issue focused on: Altogether, the complexity of HIV-1 diversity establishes increasing challenges for development of preventive, therapeutic and functional cure approaches towards the goal to end the pandemic.We hope that four published scientific articles could provide new outlooks on studying HIV and AIDS from different perspectives including resistance testing before ART, longitudinal trajectory analysis of multiple immune indicators, development of newer ART regimens and early ART initiation in PHIV, and the importance of combined molecular surveillance and epidemiology.The author declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.