Immune Checkpoint Inhibitors and HIV Reservoir Persistence: Therapeutic Implications and Challenges

Taliikwa Nicholas Ceaser

Department of Pharmacognosy Kampala International University Uganda

Email:ceaser.taliikwa@studwc.kiu.ac.ug

ABSTRACT

Human immunodeficiency virus (HIV) persisted in latent reservoirs despite effective antiretroviral therapy (ART), presenting the primary barrier to achieving a functional cure. Immune checkpoint inhibitors (ICIs), originally developed for cancer immunotherapy, have emerged as promising agents for reversing HIV latency by modulating T-cell exhaustion pathways. This narrative review critically synthesized current evidence on the therapeutic potential and challenges of ICIs in targeting HIV reservoirs. A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases (2015–2024) using keywords related to immune checkpoint inhibitors, HIV latency, viral reservoirs, and T-cell exhaustion. Principal findings indicated that programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) blockade can enhance HIV-specific immune responses and induce viral reactivation in vitro and in animal models. However, clinical trials in people living with HIV (PLWH) have demonstrated modest effects on reservoir reduction, with significant inter-individual variability and potential immune-related adverse events. Combination approaches integrating ICIs with latency-reversing agents and therapeutic vaccines showed promise but required optimization. The review concludes that while ICIs represent a rational therapeutic strategy for HIV reservoir elimination, substantial challenges remain in achieving clinically meaningful reservoir depletion. Enhanced understanding of checkpoint molecule dynamics, personalized treatment algorithms, and novel combination regimens are essential for translating this approach into effective cure strategies.

Keywords: Immune checkpoint inhibitors, HIV latency, Viral reservoir, T-cell exhaustion, Functional cure

CITE AS: Taliikwa Nicholas Ceaser (2026). Immune Checkpoint Inhibitors and HIV Reservoir Persistence: Therapeutic Implications and Challenges. RESEARCH INVENTION JOURNAL OF BIOLOGICAL AND APPLIED SCIENCES 6(1):102-110. https://doi.org/10.59298/RIJBAS/2026/61102110