There’s currently no cure for HIV, but many clinical studies are dedicated to researching a cure. The current antiretroviral treatments allow people living with HIV to prevent its progression and to live normal life spans.
Great strides have been made toward the prevention and treatment of HIV, thanks to:
- public health officials
- governmental agencies
- community-based organizations
- HIV activists
- pharmaceutical companies
- engineer certain immune system cells to reactivate HIV in cells that contain inactive, or latent, HIV
- use another set of engineered immune system cells to attack and remove cells with reactivated HIV
Their findings could provide the foundation for an HIV vaccine. Clinical trials are in the works.
- Sexual contact. During sexual contact, HIV can be transmitted through the exchange of certain fluids. They include blood, semen, or anal and vaginal secretions. Having other sexually transmitted infections (STIs) can increase the risk of HIV transmission during sex.
- Shared needles and syringes. Needles and syringes that have been used by a person with HIV may contain the virus, even if there’s no visible blood on them.
- Pregnancy, delivery, and breastfeeding. Mothers with HIV can transmit the virus to their baby before and after birth. In instances where HIV medication is used, this is extremely rare.
Taking certain precautions may protect a person from contracting HIV:
- Get tested for HIV. Ask sexual partners about their status before having sex.
- Get tested and treated for STIs. Ask sexual partners to do the same.
- When engaging in oral, vaginal, and anal sex, use a barrier method like condoms every time (and use it correctly).
- If injecting drugs, make sure to use a new, sterilized needle that hasn’t been used by anyone else.
- men who have sex with men, if they’ve had anal sex without using a condom or have had an STI in the last six months
- men or women who don’t use a barrier method like condoms regularly and have partners with an increased risk for HIV or an unknown HIV status
- anyone who has shared needles or used injected drugs in the last six months
- women who are considering conceiving with HIV-positive partners
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- A person thinks they may have been exposed to HIV during sex (e.g., the condom broke or no condom was used).
- A person has shared needles when injecting drugs.
- A person has been sexually assaulted.
PEP should only be used as an emergency prevention method. It must be started within 72 hours of possible exposure to HIV. Ideally, PEP is started as close to the time of exposure as possible. PEP typically involves a month of adherence to antiretroviral therapy.
- Reduce viral load. The viral load is a measure of the amount of HIV RNA in the blood. The goal of HIV antiretroviral therapy is to reduce the virus to an undetectable level.
- Allow the body to restore its CD4 cell count to normal. CD4 cells are responsible for protecting the body against pathogens that can cause HIV.
There are several types of HIV drugs:
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) disable a protein that HIV uses to make copies of its genetic material in the cells.
- Nucleoside reverse transcriptase inhibitors (NRTIs) give HIV faulty building blocks so it can’t make copies of its genetic material in the cells.
- Protease inhibitors disable an enzyme that HIV needs to make functional copies of itself.
- Entry or fusion inhibitors prevent HIV from entering the CD4 cells.
- Integrase inhibitors prevent integrase activity. Without this enzyme, HIV can’t insert itself into the CD4 cell’s DNA.
HIV drugs are often taken in specific combinations to prevent the development of drug resistance. HIV drugs must be taken consistently to be effective. An HIV-positive person should talk with their healthcare provider before considering switching medications to reduce side effects or because of treatment failure.
- 90 percent of all people living with HIV to know their status
- 90 percent of all people diagnosed with HIV to be on antiretroviral medication
- 90 percent of all people receiving antiretroviral therapy to be virally suppressed
A monthly HIV injection is scheduled to become available in early 2020. It combines two drugs: the integrase inhibitor cabotegravir and the NNRTI rilpivirine (Edurant). Clinical studies found that the monthly injection was as effective at suppressing HIV as the typical daily regimen of three oral medications.
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 or eliminate the cells that are actively reproducing the virus. Antiretroviral therapy doesn’t eliminate HIV reservoirs.
- Functional cure. This type of cure would control replication of HIV in the absence of antiretroviral therapy.
- Sterilizing cure. This type of cure would completely eliminate the virus that’s capable of replicating.
Breaking apart the HIV virus
Researchers at the University of Illinois at Urbana-Champaign have been using computer simulations to study the HIV capsid. The capsid is the container for the virus’s genetic material. It protects the virus from being destroyed by the immune system. Understanding the makeup of the capsid and how it interacts with its environment may help researchers find a way to break it open. Breaking the capsid could release HIV’s genetic material into the body where it can be destroyed by the immune system. It’s a promising frontier in HIV treatment and cure.
Timothy Ray Brown, an American once living in Berlin, received an HIV diagnosis in 1995 and a leukemia diagnosis in 2006. He’s one of two people sometimes referred to as “the Berlin patient.” In 2007, Brown received a stem cell transplant to treat the leukemia — and stopped antiretroviral therapy. HIV