Advancing Options for Gene Editing for HIV-1

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Excision BioTherapeutic’s CRISPR gene-editing therapy, EBT-101, was granted Fast Track designation by the FDA. EBT-101 is an injection given once that acts as a functional cure of HIV-1.

Excision BioTherapeutic was able to cure a nonhuman primate of SIV, the simian version of HIV.

It has been over 40 years since the first case of HIV was diagnosed and there has not been a cure invented because of the complexities of the HIV RNA. Current treatments help to suppress the HIV load from increasing and prevent the disease from turning into AIDS. With this antiretroviral therapy (ART), a person infected with HIV can lead a very long life with minor complications.

EBT-101 would be groundbreaking for the world of HIV. However, depending on the cost of EBT-101, would it be accessible to everyone?

Today, 30% of HIV patients cannot afford access to proper HIV treatment because of the cost. On top of that, It is predicted that a patient will spend about $300,000 on HIV treatment over the course of their life once they have been diagnosed with the disease.

CRISPR gene-editing therapy is predicted to cost about $1 million dollars per person which is considerably more expensive than keeping a patient on ART for the rest of their life. It remains to be seen whether insurance companies will cover EBT-101 if gets approved or will they continue to keep their patients on ART.

Meanwhile, there is a HIV vaccine trial combined with preexposure prophylaxis (PrEP) underway to study the efficacy of preventing of HIV. The study, called PrEPVacc, is an African-led, European-supported HIV prevention study that completed enrollment earlier this year. The participants received one of two experimental vaccines and were also offered PrEP. If PrePVacc were to show high efficacy in the prevention of HIV, insurance companies may be more willing to cover it for their patients because vaccines and prevention are typically less costly to treatment, especially when treatment must continue throughout a person's life as it currently must do for HIV infection.

Nkiru Okonkwo is a Pharm.D. candidate at Duquesne University’s School of Pharmacy in Pittsburgh who is expected to graduate in spring 2024. She completed this article while on Advanced Pharmacy Practice Rotation at STACK, which focused on specialty pharmacy, technology, and entrepreneurship.