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Cure

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.

What We're Reading

This study published in PLoS explored the potential of ART-free remission in the case of an individual provided treatment at one of the earliest stages of HIV infection. Undetectable infection achieved at this very early stage did not lead to indefinite ART-free remission, but may be associated with longer periods of remission.

November 7, 2017
PLoS

Plus reports on mouse study investigating a new drug. The findings show it may stop HIV at a much earlier point in the life cycle of the virus, which represents a significant step in research for a cure.

October 24, 2017
Plus Magazine

KQED Science reports on the status of scientific research into a cure for HIV. Leading researchers explain findings that suggest latent HIV may be “difficult to impossible” to eradicate, but the possibility of sustained remission (even without daily drug treatment) is an exciting area of inquiry. AVAC’s Jessica Salzwedel frames crucial questions related to research on remission.

September 28, 2017
KQED
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