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Cure vs Treatment

Sep 18, 2011

Dear Doc,

Sorry for my naivety but as a newly diagnosed patient, 7 weeks into treatment and fingers crossed on the road to undetectable status, I am wondering what the differences are between being stable on HAART therapy and being cured of HIV.

I understand that only 2% of the virus is in the blood. Where is the other 98%? Also, if the virus is undetectable in your blood how is the assumption made that the virus is not undetectable in these other places? Is it possible that some people are walking around with the virus in full suppression by the treatment?

Response from Dr. Holodniy

All great questions. The virus exists in two major forms, cell-free virus that circulates in the blood (what we measure as viral load); and provirus, which is integrated into the DNA of cells (primarily CD4 t cells). The CD4 cells and other cell types that are infected circulate in the blood, but also reside in various organs (lymph nodes, brain, genital tract, etc). The provirus form is essentially impossible to clear with current HIV treatment, which only works on replicating virus, so shutting virus production down, but not getting rid of the infected cells. That is why current HIV treatment will control the infection, but not cure it.

Cd4-CD8, toxoplasmosis
Viral load

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