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HIV Progress Report: Are We Close to a Cure?

HIV and AIDS

Key points

  1. There’s still no cure for HIV.
  2. There have been several cases of individuals with HIV who’ve been functionally cured of HIV.
  3. Clinical trials and additional scientific research continue to make strides toward finding a cure for HIV.

HIV is a virus that infects your body and weakens your immune system. An HIV infection can develop into the potentially fatal disease AIDS. HIV and AIDS hinder your body’s ability to fight disease.

The AIDS epidemic began in the United States in the 1980s. The World Health Organization (WHO) estimates that HIV has claimed over 35 million lives since it was first discovered.

There’s currently no cure for HIV or AIDS. However, there are many clinical studies dedicated to researching a cure, and scientists have made great strides toward preventing and treating HIV infections.

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Prevention

Prevention

Vaccine

The development of a vaccine for HIV would save millions of lives. However, researchers haven’t yet discovered a perfect vaccine for HIV.

In 2009, a study published in the Journal of Virology found that a vaccine prevented about 31 percent of new infections. However, further research was stopped due to dangerous risks.

In early 2013, the National Institute of Allergy and Infectious Diseases stopped a clinical trial that was testing injections of the HVTN 505 vaccine. Data from the trial indicated the vaccine didn’t prevent HIV infection or reduce the amount of HIV in the blood.

Basic prevention

While no vaccine is yet available for HIV, there are ways to protect against infection.

HIV is primarily transmitted through the exchange of bodily fluids. This can happen in a variety of ways including:

  • Sexual contact: HIV can be spread through the exchange of certain fluids during sexual contact including blood, semen, or vaginal secretions.
  • Blood transfusions: You may contract HIV if you receive a blood transfusion from a blood donor who has the disease. Screening blood for HIV before transfusions has greatly reduced the likelihood of this happening.
  • Shared needles and syringes: Needles and syringes that have been used by a person with HIV or AIDS can be contaminated with HIV.
  • Pregnancy, delivery, and breast-feeding: Mothers with HIV can infect their baby before and after birth.

Taking precautions to prevent transmission of HIV through these common routes may protect you from contracting the disease. Here are a few tips for protecting yourself:

  • Get tested for HIV and know your partner’s status before you have sex.
  • Get tested and treated for sexually transmitted diseases.
  • Use condoms correctly every time you have sex.
  • Don’t inject drugs. If you do, make sure to use a sterile needle that hasn’t been shared with others.

Pre-exposure prophylaxis

Pre-exposure prophylaxis (PrEP) consists of daily medications used to lower the chances of getting infected with HIV. It’s designed to prevent the transmission of HIV in high-risk populations. Populations at risk can include:

  • men who have sex with men, if they’ve had anal sex without using a condom or had an STD in the last six months
  • men or women who don’t use condoms regularly with partners at high risk of HIV infection and of unknown HIV status
  • anyone who has injected drugs in the last six months or shared needles
  • women who are considering getting pregnant with HIV-positive partners

According to the Centers for Disease Control and Prevention, PrEP can reduce the risk of HIV infection by up to 92 percent in populations who are at high risk if taken consistently. PrEP isn’t as effective if it isn’t taken consistently.

Post-exposure prophylaxis

Post-exposure prophylaxis (PEP) consists of taking antiretroviral drugs after you think you may have been exposed to HIV. Your doctor may recommend PEP in the following situations:

  • You think you may have been exposed to HIV during sex (the condom broke or no condom was used).
  • You’ve shared needles when injecting drugs.
  • You’ve been sexually assaulted.

PEP should be used only as an emergency prevention method. You must start it within 72 hours of exposure, though ideally you’d start as close to the time of exposure as possible. Your doctor may prescribe multiple drugs for this procedure.

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Diagnosis

Proper diagnosis

Diagnosing HIV and AIDS is a vital step toward preventing the spread of the disease around the world. WHO estimates that 40 percent of the 18 million people with HIV don’t know they have the disease. HIV self-tests allow people to test their oral fluid or blood in a private setting and receive a result within 20 minutes.

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Treatment

Steps for treatment

Thanks to advances in science, HIV can be a manageable chronic disease.

WHO estimates that more than 80 percent of all people diagnosed with HIV receive some type of antiretroviral therapy. According to the National Institute of Health (NIH), 31 antiretroviral drugs have been approved by the Food and Drug Administration.

These HIV drugs do two things:

  • Reduce your viral load: The viral load is a measure of the amount of HIV RNA in your blood.
  • Restore your body’s CD4 cell count to normal: CD4 cells are responsible for protecting your body against organisms that can cause infection.

There are several types of HIV drugs:

  • Non-nucleoside reverse transcriptase inhibitors disable a protein in your body in order to prevent HIV from making copies of itself in your cells.
  • Nucleoside reverse transcriptase inhibitors give HIV faulty building blocks so it can’t make copies of itself in your cells.
  • Protease inhibitors disable an enzyme HIV needs to create copies of itself.
  • Entry or fusion inhibitors prevent HIV from entering your CD4 cells.
  • Integrase inhibitors prevent the release of integrase. Without this protein, HIV can’t insert itself into your CD4 cells.

HIV drugs are often taken in various combinations to prevent the development of drug resistance. HIV drugs must be taken consistently to be effective.

Antiretroviral HIV Drugs: Side Effects and Adherence »

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Research

Milestones in research

Researchers are hard at work looking for new drugs and treatments for HIV and AIDS. They are aiming to find therapies that extend and improve the quality of life for people with these diseases. In addition, they hope to develop a vaccine and discover a cure for HIV and AIDS. Here’s a brief look at several important studies:

“Functionally cured”

A man in Berlin with HIV received chemotherapy, total body irradiation, and stem cell transplantation. HIV hasn’t been detected in “the Berlin patient” for over 6 years. Studies of multiple parts of his body at the University of California, San Francisco have shown him to be free of HIV. He is considered “effectively cured,” according to the NIH.

In early 2013, NIH announced that a 2-year-old child in Mississippi who was born to an HIV-positive mother had been “functionally cured” of HIV. Doctors administered antiretroviral treatment during the infant’s first day. The baby remained on the antiretroviral therapy for the first 18 months of life, and doctors performed regular blood tests to check the levels of HIV. Ten months after stopping medication, the baby was still HIV free as far as the tests could detect. Many researchers considered the child to be “functionally cured.” However, two years after ending antiretroviral therapy, it was discovered the child had developed detectable levels of HIV.

Targeting HIV reservoirs

Part of what makes discovering a cure for HIV difficult is that the immune system has trouble targeting reservoirs of cells with HIV. The immune system usually can’t recognize cells with HIV nor can it eliminate the cells that are actively reproducing the virus.

Antiretroviral therapy doesn’t eliminate HIV reservoirs. So NHI researchers are exploring two categories in the search for an HIV cure:

  • Functional cure: This type of cure would control replication of HIV.
  • Sterilizing cure: This type of cure would completely eliminate the part of the virus responsible for replicating.

These cures would potentially destroy HIV reservoirs.

Clean genes with computers

Researchers at the University of Illinois at Urbana-Champaign may have discovered a way to clean cells of the HIV virus. The HIV virus hides in a cell’s capsid, the part of the cell that stores genetic material. Using high-powered supercomputers, researchers may be able to create a formula for revealing the hidden HIV in a cell’s capsid.

If science can crack the capsid, the cell can release the HIV, and then your immune system can attack the HIV to kill it. It’s a promising frontier in HIV treatment and cure, but it’s only been tested in computers so far.

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Takeaway

Where we are now

Thirty years ago, researchers barely understood HIV, let alone how to treat or cure it. Over the decades, advances in technology and medical capabilities have brought more advanced HIV treatments.

Medicine can now slow the progression of HIV and prevent moms from sharing the virus with their children. Targeted drug therapy can decrease a person’s viral load to almost undetectable levels.

Each year, hundreds of clinical trials aim to find better treatments for HIV in the hopes of one day finding a cure.

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