Hi Dr.Thanks for all you do! My questions/comment are: I frequently hear, "We only have HAART data for 10 years, 12 years, etc.. 12Years of HAART data is nothing to scoff at when it comes to statistical analysis/extrapolation. My profession is directly involved with the interpretation of statistics, as I'm asked to extrapolate data for a year based on one month's data and the results are frequently surprisingly accurate... My question is When someone stays undetectable, does the infected 'resting' hiv infected CD4 population behave the same in every one? I mean do we know that every person's virus would behave the same way if medication was stopped..I question this because of Fauci's recent analysis on resting cell populations and the newly infected... Is it at least possible that in some people there is a mechanism that would keep the resting population in a resting state indefinitely as long as lifestyle was conduscive to immune health? Thank You

Yes, it appears that HIV-infected resting cells behave similarly in different people. The discouraging take home point from the presence of infected resting cells is that HIV cannot be eradicated with our present treatments, so HIV infection is life long.

Still, there is an interesting additional answer to your intriguing point. One avenue of treatment research at present is a maturation inhibitor that could be active on HIV in macrophages, which are among the HIV infected resting cell populations, in order to essentially limit the virus and the cell's ability to switch from the resting to the active state and produce additional virus. This is a long way from being ready for use now, but the concept is intriguing and under investigation.