Immunotherapy for HIV Treatment and Cure in the Era of Personalized Medicine

HIV immunotherapy encompasses antiviral maintenance, immune restoration, treatment of inflammatory morbidity and attempts to achieve remission or eradication. Broadly neutralizing antibodies have prolonged control after antiretroviral therapy withdrawal in randomized trials, although residual antibody activity complicates interpretation of remission. Therapeutic vaccines, checkpoint inhibitors and engineered effectors offer complementary mechanisms, with variable clinical activity and toxicity. These findings, together with reservoir and (multi-)omic studies, support matching interventions to viral susceptibility, immune competence and treatment exposure. The evidence for using host profiles to assign immunotherapy remains limited, however. This review examines the transition from biological stratification to clinically validated personalization. Natural controllers illustrate how virological containment can coexist with inflammation, while phenotyping studies reveal heterogeneity within conventional clinical groups. Longitudinal mathematical models can connect these observations with changing drug exposure and viral escape. Prospective randomized studies are needed to establish whether immunogenetic, immunophenotypic or model-guided treatment assignment improves outcomes beyond conventional selection. Durable virological control, immune health, safety and treatment burden together determine the clinical value of this approach.