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A cure for HIV infection is one of the ultimate long-term goals of research today. The science is expanding, raising hopes and challenges.
The term “cure” refers to a strategy or strategies that would eliminate HIV from a person’s body, or permanently control the virus and render it unable to cause disease. A range of types of cures are being discussed today. A “sterilizing” cure would completely eliminate the virus. A “functional” cure would suppress HIV viral load, keeping it below the level of detection without the use of ART. The virus would not be eliminated from the body but would be effectively controlled and prevented from causing any illness. The term “remission” is also used and it means the virus is undetectable using the most sensitive tests but could return because small numbers of copies remain. It’s important to know that researchers are still figuring out exactly how to define these types of HIV cures. Although some possible cases of functional cures have been reported, it takes time to be certain that HIV can no longer cause disease, because it is known that even very low levels of virus can increase the risk of certain illnesses and ultimately lead to AIDS.
The cure strategies currently under investigation are, in many cases, potentially toxic and carry risks for people undergoing them. Figuring out how to communicate the risks and benefits of cure strategies to potential trial participants will be an important part of any cure clinical trial. In order to test whether a person has been cured, they need to stop effective antiretroviral treatment so that viral rebound, if any, can be measured. There are no standardized guidelines for how to time such “treatment interruptions” so that they minimize risks for cure trial participants. Finally, cure strategies may look different for men, women and children—biological differences between sexes and differences in adult versus pediatric immune systems mean that it is unlikely there will be a “one size fits all” cure approach. AVAC is working with partners to track, translate and accelerate cure research.
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