Globally, close to 37.7 million people live with HIV, with around 1.1 million individuals being American citizens. Even though the antiretroviral therapy (ART) has been widely implemented with subsequent validation of “undetectable = untransmittable” concept, over 1.7 million fresh cases emerge annually with nearly 770,000 deaths attributable to HIV. The cure for HIV remains elusive despite it being a priority ever since the virus’ discovery.
HIV Cure: Challenges
ART targets viral replications only in activated cells. It has no effect on latent virus, that is the large amount of virus hiding in memory of the inactive T cells. This is HIV cure’s biggest challenge because viral latency tends to be reversible process when effective ART is absent.
— defeatHIV (@defeatHIV) June 22, 2020
For further complicating the viral latency, a latent reservoir may emerge in human body compartments that were spared from ART and immune recognition of both cellular and physical barriers. For instance, the blood-brain barrier, the B-cell follicles in lymph nodes, and the Sertoli cell layer of the testes.
Nevertheless, there two, or possibly three eradicative cures that exist today. HIV requires a second coreceptor for infecting a cell, in addition to the CD4 reception. CCR5 is one such reception, and it is congenitally missing in 0 to 2.3 percent of individuals.
ART is not solving the pandemic.
In 2018, 770,000 died of HIV/AIDS related diseases.
— Brian W (@IntrepidBrian) June 23, 2020
None of the individual approaches of HIV cure have been able to achieve long-term viral remission. However, ART’s early initiation following the HIV diagnosis has been correlated with varying results of post-treatment control, decreasing residual replication of virus, reducing viral reservoir, and enhancement of the immune response.
HIV Cure: Current Situation
Although the current research has so far been unable to elucidate the path to a cure, it remains highly active and prioritized with emerging science and promising mechanisms of novel drugs. With the ultimate goal of bringing the HIV’s story to its conclusion, the evolving methods have redefined the HIV cure’s concept.