Effectiveness of Exosome-Delivered siRNA Therapy Versus Broadly Neutralizing Antibodies on HIV Viral Load Suppression: A Review

Zakaria Ali

Department of Pharmacy Kampala International University Uganda

Email:ali.zakaria@studwc.kiu.ac.ug

ABSTRACT

HIV continues to pose significant global health challenges, with antiretroviral therapy (ART) providing effective viral suppression but failing to eliminate latent reservoirs. To address this limitation, recent research has explored novel therapeutic strategies, such as exosome-delivered small interfering RNA (siRNA) and broadly neutralizing antibodies (bNAbs), both of which aim to achieve more durable viral control or a functional cure. This review was conducted to compare the mechanisms, clinical effectiveness, and translational potential of these two emerging therapies in reducing HIV viral load in individuals receiving or transitioning from ART. A narrative review methodology was used, synthesizing relevant peer-reviewed literature published between 2010 and 2025 across preclinical and clinical settings. Findings show that exosome-delivered siRNA offers targeted gene silencing with high specificity and reduced toxicity, although current evidence remains limited to experimental models. In contrast, bNAbs have demonstrated significant reductions in viral load and delayed rebound in clinical trials, particularly when used in combination or sequential dosing strategies. Despite their potential, both therapies face limitations, including delivery challenges, the risk of viral resistance, and concerns regarding scalability. In contrast, while bNAbs are closer to clinical application, exosome-based siRNA therapy holds considerable promise and warrants further investigation. A combinatory or personalized approach may represent the most viable pathway toward functional HIV remission.

Keywords: HIV viral suppression, Exosome therapy, siRNA delivery, Broadly neutralizing antibodies, Functional HIV cure.

CITE AS: Zakaria Ali (2025). Effectiveness of Exosome-Delivered siRNA Therapy Versus Broadly Neutralizing Antibodies on HIV Viral Load Suppression: A Review. NEWPORT INTERNATIONAL   JOURNAL OF SCIENTIFIC AND   EXPERIMENTAL SCIENCES 6(3):70-74 https://doi.org/10.59298/NIJSES/2025/63.7074