Dear Doctor,

Is it too far fetched for medical science now to guide hiv into specific mutations that would eventually become harmless? As far as I know, frequent mutations of retroviruses are seen as an obstacle for treatment, but, couldn't that characteristic be used in favor of therapy? I'm thinking here in sort of a breeding of the virus so that it eventually evolves into a variety that is harmless, or easily treatable.

Thanks. You are doing a phenomenal work!

This is an idea shared by many people and currently under investigation. My personal opinion, HIV is not likely to be rendered harmless by resistance mutations. We are certainly studying the question in patients who have developed multiple mutations, but I would not (any time soon) support the intentional generation of resistance mutations to facilitate the study of this question. There are unfortunately too numerous to count examples of patients with markedly drug resistant virus who continue to mount very high viral loads associated with HIV disease progression. But - we are continuing to investigate this and related ideas.