Although the combined antiretroviral drug or cART therapy has proven the reduction of HIV-related issues up to an extent, HIV can’t be cured. The treatment lacks an effective anticipatory and therapeutic vaccine. As the number of infected people is increasing with new toxicities. There is an urgent need for an effective vaccine to increase the lifespan of people with AIDS. But the question is will HIV ever be curable? If so, how long will it take?
We will encounter the necessary things to know about HIV and its progression in treatment. Undoubtedly, achieving a high efficacy treatment such as long-term control of HIV without medicines or elimination of HIV-infected cells is a big challenge. Moreover, studies have revealed that treatment augmentation has little effect on latent reservoirs. However, some approaching and promising methods included in reducing the latent reservoirs are early detection and initiation of antiretroviral drugs and the use of potential agents which could potentially revert the latent phase.
What happens in latent HIV infection?
Well, HIV is a dangerous virus. It doesn’t mean our body doesn’t do anything to stop it. There are various barriers to HIV that try to stop the establishment of clinical latency or silent infection in the existing CD4+T cells. What happens in a latent infection? In this phase of latency, HIV can incorporate into the host cell genome, but can’t be able for further replication. Consequently, the immune system of antiviral drugs is inadequate to terminate these latently infected cells.
If the cART is stopped, reactivation will take place again in the latently infected (CD4+T) resting cells. Another significant barrier to stop this residual replication of the virus is the consumption of antiretroviral drugs even when there is no virus detection by the conventional assays. Furthermore, HIV can be concealed in anatomical reservoirs like the brain, GIT(gastrointestinal tract), and GUT(genitourinary tract).
Potential agents reverting latent infection will promote viral replication. And a concurrent administration of antiretrovirals will prevent a coming series of viral replication. Some cART drugs are histone deacetylase inhibitors that are being used and licensed currently for the activation of latently infected resting cells, with cytokines for e.g IL-7 or prostratin, and showed optimistic results in reverting latency when used either used solo or in combination. There is a need for carefulness while moving forward towards the clinical trials aiming elimination of HIV with full consideration of the benefits and risks involved in these approaches.
So, are you aware of what brought this combination of antiretroviral therapy into knowledge?
Importance of cure of HIV
Even though there is a successive improvement ratio of cART therapy, still there is a need to increase the lifespan of the HIV survivors. Even with the potent drugs, there is no full life expectancy of HIV-infected individuals.
One report on a prospective study in Denmark happened among 39990 HIV infected individuals and 379,872 HIV uninfected, the chances of survival were investigated in the period prior:-
- cART therapy(1995-1996)
- During early cART( 1997-1999)
- During late cART(2000-2005)
Hence, there was a considerable and clear increase in the surviving rate following the administration of cART in the late 1990s. Nonetheless, the life expectancy remained notably less than usual, a population controls even in the late cART. The probability of HIV-infected individuals reaching 70 was 50% than the uninfected ones. Overall these studies are consistent and highly observed from other large studies.
Although there is global access to cART therapy and the further development of the health system, still there is a lack of sufficient financial resources to hold up the lifelong treatment for every infected individual. Spotting everyone who needs treatment is quite harder because the treatment recommendations will move to earlier initiation of cART treatment, which will eventually raise the population judged as the needy of treatment even if they are not. Eventually, the new HIV-infected cases will continue to shake off the number of people having treatment.
Even after the rapid rise of the cART in recent years, five new infections were occurring for every two people who started the treatment. And this imbalance is hard to overcome in the future as well, despite evidence that HIV cases are declining with the promise of more potent biomedical interventions that includes circumcision and tenofovir-containing microbicides.
So, coming back to our main concern, will HIV ever be curable? Are we close to a cure for HIV? Let’s discuss what can happen in the future.
Will HIV ever be curable?
Scientists and researchers believe that a cure for HIV will be found. As we know about HIV a lot, just like certain cancers. The clinical strategy for a cure for HIV is divided into two categories: functional cure and sterilizing cure.
As there is no natural or herbal cure available for HIV. cART therapy is the only treatment that can benefit in controlling HIV. Here, let’s jump into these cures.
A functional cure is believed to reduce the levels of HIV in the body so that it can’t be detected or able to make you ill. However, it wouldn’t completely let the virus go. Some believe that ART is the functional cure for this, while most believe that a functional cure is something after which the virus wouldn’t need a lifetime treatment to suppress.
Well, there are a few examples of people who get functionally cured like Mississippi baby, but in most cases, the virus re-emerged. Most people received the ART treatment just after the infection.
A sterilizing cure works by eliminating the HIV from the body, also from the hidden reservoirs: that are the cells that are infected by HIV in the early stages of infection but aren’t actively producing HIV. Till now, there are only two examples of such cures: timothy brown (berlin patient) and adam Castillejo( London patient).
Timothy Brown had chemotherapy and bone marrow transplant in 2007-2008 to treat leukemia. His transplant was done by someone who was genetically resistant to HIV. As a result, he appeared cured of HIV. After this, amazing achievement, doctors copied the results on Castillejo, and finally in 2020 confirmed that he was HIV-free even after stopping the treatment for 30 months.
Despite the success of these two experiences, this procedure isn’t suitable for all individuals as bone marrow transplant is a quite invasive and risky process.
As there are continuous researches and observations on how to cure HIV. Scientists and researchers have come up with 4 main approaches to cure HIV:-
4 main approaches to cure HIV
Activate and eradicate( shock or kill):- this method aims to eradicate the virus out of its reservoir and kill the infected cells.
Gene editing:- this includes changing immune cells, so they won’t be affected by HIV.
Immune modulation:- involves changing the immune system wholly to better make it get rid of HIV.
Stem cells transplant:- it is the transplantation of an infected immune system with a donor’s immune system.
Although the stem cell approach has been proven effective in the past, it can be very dangerous to people. A stem cell transplant would only be considered an applicable option if the person urgently needs it for treating some other deadly condition like very advanced leukemia. And which haven’t had other safe and effective options available like HIV.
Whenever we find a cure for any disease, it comes to vaccination. Most of the dangerous diseases like polio, chickenpox have been cured by vaccines only. Similarly, in the case of HIV, there is a strong need for a vaccine. But will we ever get a vaccine for HIV? Or will HIV ever be curable?
Vaccine for HIV
However, numerous vaccine trials have shown encouraging results, we are still a long way from an effective vaccine. In addition, a vaccine would only provide partial protection and would be needed along with other preventive measures.
What should you do until there is no cure for HIV?
As for now, the best thing is to take a regular test for HIV. Only testing is the only way to know if you have the virus. In case you tested positive for the virus, start your antiretroviral treatment as soon as possible. You will also prevent your sexual partner from the infection. With the right treatment, HIV individuals can live long.
Hiv is not curable in the present time. Though treatment is available, the expected life span is somehow low. As of now, 4 approaches are there to cure HIV, however, they are not suitable for every infected individual. Science is very effective nowadays, but we can’t achieve a better option for HIV treatment or discover a cure with science alone. There should be the contribution of scientists, industries, government, and politicians to encourage the need and embrace the work towards the path of finding a cure for HIV.
Frequently Asked Questions:-
Who found the cure for HIV?
Timothy Brown, also popular as “the Berlin patient” was the first person who achieved cure of HIV. In 2008 an official announcement was made at the conference on retroviruses and opportunistic infections. He is called by the Berlin patient to maintain his anonymity.
Will there be a vaccine for HIV?
Currently, there is no licensed HIV vaccine in the market, though multiple research is continuously happening and various trials are making efforts to find an effective vaccine soon.
Is Timothy Ray Brown still alive?
Where is CCR5 found?
They are a kind of protein, that is found on the surface of white blood cells, knotted with the immune system while acts as a receptor for chemokines. in humans, the ccr5 gene responsible for encoding ccr5 protein is tracked down on the short arm at position 21 on chromosome 3.
How was the Berlin patient cured?
He got a stem cell transplant from a donor genetically resistant to HIV and has not taken ART from the first days of the transplant.
Moreover, their stories were recorded in the 2014 book, cured: the people who defeated HIV (2015) by Nathalia holt.
When did Timothy Brown die?
He died on April 4, 2020. He worked as a correctional officer in Los Angeles in his later years. He died at the age of 82, due to dementia. He was residing in the palm, springs California after his retirement in the 2000s.
What CD4 stand for?
CD4 means a cluster of differentiation 4. As per molecular biology, it’s a glycoprotein that acts as a co-receptor for the T-cell receptor. They can be found on the surface of immune cells such as t helper cells, macrophages, monocytes, and dendritic cells.
How long will it take to find a cure for HIV?
Clinical trials often take a long time, about 8-10 years for the conclusion. the aim is to find an effective vaccine soon.
Can HIV go away on its own?
Not at all. Hiv is not like some other condition that will automatically go out over time. As there is no cure for HIV yet. Yes, it can be managed up to an extent if the person begins treatment before HIV ruins the immune system.
How long can you stay undetectable?
Hiv load can be considered “durably undetectable” when at least for six months they are tested undetectable after the first undetectable results. Hence a person needs to continue treatment for at least 7-12 months to achieve undetectable results.