Can HIV Infection Be Cured?
July 23, 2014
Table of Contents
In 1981, several cases of rare pneumonia (PCP, see Fact Sheet 515) and skin cancer called Kaposi's sarcoma (see Fact Sheet 511) were reported. These cases were in homosexual men in Los Angeles and New York City. This was a mystery to researchers.
The virus that causes AIDS was identified in 1983. No medications were available to treat this disease until 1987. In that year, a cancer drug called zidovudine (AZT) was found to slow down the multiplication of the Human Immunodeficiency Virus (HIV.)
By 2011, over 30 medications had been approved to fight HIV. None of these drugs kills the virus. Each of them slows down HIV at a specific point of its life cycle (see Fact Sheet 106.)
In 1996, several research studies suggested that triple-drug combinations could drive HIV into remission or eradicate it. Many people taking combinations of antiretroviral medications have an undetectable viral load (see Fact Sheet 125.)
However, by some estimates, only 2% of the virus in the body is in the blood, where it can be measured by viral load tests. Even in patients taking potent triple medication combinations, HIV was not eradicated.
Very early in HIV infection, the virus becomes part of the genetic code of millions of cells. Some of these cells are hidden from the immune system, and from antiviral medications. Areas where the virus is hiding are called reservoirs. These include the genital tract and the central nervous system. One researcher estimated that it might take 70 years of controlling HIV to eliminate these reservoirs.
Another boost to hopes for an HIV cure came from the "Berlin patient." This was a person with HIV living in Berlin who also had leukemia. Standard leukemia treatment failed. He then received a bone marrow transplant. This wiped out his immune system. It was replaced from a donor with a rare genetic mutation that made him resistant to HIV infection. When the treatments were completed, the Berlin patient had no sign of HIV in his body.
Bone marrow transplants are dangerous. As many as 1/3 of patients who get them die from the procedure. Therefore, it is not clear that the success of the Berlin patient could or should be tried in anyone else. However, this case provides some clues about how HIV might be removed from a patient.
In 2013, several AIDS researchers reported "cure" results. These were not carefully designed as cure studies. However, for the individuals involved, the results were considered a "functional cure." This means that even without antiretroviral therapy, their viral load stayed under control.
An infant girl in Mississippi given antiretroviral drugs soon after birth was thought to be cured of her HIV, but a recent report shows that her virus has returned.
This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.
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