Gladstone Institutes Identifies Common Diabetes Medication Metformin as Potential Key to Long-Term HIV Remission

Gladstone Institutes researchers find that the diabetes drug metformin can lock HIV in a dormant state, offering a new path to a functional cure.

By: AXL Media

Published: Mar 20, 2026, 12:42 PM EDT

Source: Information for this report was sourced from Gladstone Institutes

A New Frontier in HIV Functional Cures

For the millions of individuals living with HIV, the necessity of a lifelong daily drug regimen remains the standard of care to prevent the virus from rebounding. However, a groundbreaking study from Gladstone Institutes has begun to decode why a rare subset of patients can maintain viral suppression for months or even years after ceasing antiretroviral therapy (ART). Dr. Nadia Roan, a senior investigator at Gladstone, noted that while the virus typically returns within weeks for most, these rare "controllers" provide a biological roadmap for achieving long term health without the constant need for pharmacological intervention.

Genetic Security Locks and Viral Dormancy

The research team identified two specific genes, DDIT4 and ZNF254, located within the CD4+ T cells that serve as the primary reservoir for HIV. These genes function essentially as security locks that maintain the virus in a dormant state, preventing it from replicating even in the absence of ART. According to Ashley George, a research scientist at Gladstone, these findings support a promising "block and lock" strategy. This approach focuses on using specific compounds to first block the activation of the virus and then permanently lock it into an epigenetic slumber, potentially transforming regular patients into "elite controllers" who naturally suppress the infection.

The Repurposing Potential of Metformin

Perhaps the most significant clinical discovery of the study is the role of metformin, a safe and affordable medication typically prescribed for Type 2 diabetes. The researchers demonstrated that metformin can successfully boost the levels of the DDIT4 gene within T cells, effectively silencing the HIV reservoir. Lab experiments confirmed that treating infected cells with metformin inhibited the virus's ability to reactivate. Dr. Roan expressed significant interest in advancing this discovery into clinical trials, highlighting that the drug's established safety profile makes it an ideal candidate for immediate investigative efforts toward HIV remission.