Although there are many treatments available for HIV, there is no definite cure. Once infected with HIV, patients usually have to take anti-HIV medications for the rest of their lives.
While there is no cure for HIV, some HIV patients have seemingly been cured of HIV in the past. Timothy Ray Brown, also known as the Berlin patient, was the first person who was seemingly cured of HIV following a successful bone marrow transplant for his Leukemia. Adam Castillejo, a.k.a the London patient, was also cured of HIV after his doctors replicated the same results with a bone marrow transplant.
Despite the seeming success of a bone marrow transplant is not just treating but curing HIV, it is an extremely invasive, expensive, and dangerous procedure and not a viable treatment option for HIV.
A POSSIBLE CURE FOR HIV
There is no widely accepted cure for HIV. However, there are treatment options that are effective in keeping the virus in check. These treatment options include anti-retroviral drugs, or ART (anti-retroviral therapy), that directly attack the virus decreasing its physical number and, thus, increasing the immune system’s functioning capacity.
The mainstay of HIV treatment involves keeping the viral load (physical quantity of the virus in the blood) as low as possible. A low viral load means that there are not enough viral particles to overwhelm the immune system and, thus, the immune system regains most of its lost functional capacity. The goal of the treatment for HIV is to achieve and maintain undetectable viral loads. Undetectable viral loads mean that the amount of virus in the blood is so low that it can't be detected through blood tests to diagnose HIV. Once undetectable viral loads are met, patients can't usually transmit the virus to other people through sexual contact and enjoy a better quality of life.
The current treatment for HIV is very effective in keeping the virus checked. Many also consider it a functional cure (a cure that lowers the viral load so much that the virus cannot replicate). However, others argue that a functional cure would not require a patient to take medications for the rest of their life. Heavy research is being conducted to find functional and sterilizing cures (a cure that eliminates HIV from the body).
The cure for HIV that Timothy Brown and Adam Castillejo enjoyed with bone marrow transplants is peculiar because it cannot be replicated for every HIV patient. Both of these patients received a marrow transplant from a person whose genetic makeup was resistant to HIV. It is difficult to say that any such further replications would yield the same result. Moreover, both of these patients also received the transplant not primarily for HIV but for Leukemia. Bone marrow transplants are advisable and approved for the treatment of Leukemia but not for HIV. They are extremely invasive, expensive, and dangerous, so they are not done for every HIV patient out there.
There have also been people who have maintained undetectable viral loads following an HIV infection without taking any medications whatsoever. However, these people only make 1% of the global HIV-positive population. Therefore, not taking any medications for HIV in hopes that it will be cured automatically is not much of an option.
IS THERE A VACCINE FOR HIV?
There is currently no successful vaccine that helps prevent an HIV infection. Research into the development of a vaccine is underway, and some studies show positive results. However, it might still be a long time before we see a working vaccine for HIV. Prevention of HIV, however, is still possible to a great extent.
Preventative methods to protect yourself from HIV are extremely effective. Practicing safe sexual intercourse by wearing a condom, keeping the number of your sexual partners low, and getting regularly tested for HIV are all extremely successful methods of preventing HIV infections. Here are some of the ways that you can reduce your risk of contracting HIV to an absolute minimum:
- Using a condom for every sexual intercourse
- Buying a new condom for every intercourse
- Getting tested for HIV regularly
- Getting your partners tested for HIV
- Not sharing injecting needles with anyone if you use illicit drugs
- Not sharing personal hygiene products such as razors and toothbrushes with anyone
- Getting tattoos and piercings only from regulated places where the equipment is sterilized
Preventative medication regimens are also available to prevent HIV infections. PrEP, or pre-exposure prophylactic treatment, is an effective way to minimize your risk of contracting the virus to an absolute minimum – granted that you take the medication regularly and properly. PrEP is taken regularly, one pill a day, for as long as protection from HIV is required. The drugs take some time to build up enough blood concentration and then protect you if you come into contact with HIV.
Another regimen is known as nPEP, or post-exposure prophylaxis, is also a great way to prevent the development of an HIV infection even after a high-risk exposure to HIV has already occurred. However, nPEP only works if taken within 3 days or 72 hours of getting exposed to HIV. If you have been exposed to HIV during sex, such as in case of condom breakage, or if you had sex with someone whose HIV status is unknown, it is advised that you contact your healthcare provider as soon as possible.
HOW EFFECTIVE IS THE TREATMENT FOR HIV?
Treatment for HIV is extremely effective. ART, or antiretroviral therapy, is the mainstay of treatment. The main goal of HIV treatment is to keep the viral load as low as possible, ideally down to undetectable levels. Once an undetectable viral load is achieved, the transmission of the virus through sexual contact with HIV-negative people becomes virtually impossible. However, maintaining undetectable viral loads is only possible by following strict adherence to the treatment schedule.
It is important to understand that while lowering the viral load eliminates the risk of transmitting the virus through sexual contact, it does not protect against other sexually transmitted diseases (STDs). HIV-positive people are prone to acquiring other STDs as their immunity is low. Therefore, a condom should always be used for any sexual contact, even if your adherence to HIV treatment is excellent.
WHY IS THE TREATMENT FOR HIV NECESSARY?
Treatment for HIV is necessary because it carries multiple benefits. The biggest benefit of adhering to an HIV treatment schedule is that it keeps the virus in check. Undetectable viral loads eliminate the risk of HIV transmission through sexual contact, which can greatly enhance your sex life. Your partner will stay protected even if you have sexual intercourse regularly.
Moreover, effective treatment can improve your quality of life as well. When you have undetectable viral loads, your CD4+ count goes high. A high CD4+ count means that your immune system is recovering. An active immune system will then help you fight off many opportunistic infections common in HIV-positive patients.
Adhering to a strict treatment schedule and regularly taking anti-HIV medications ensures that you never develop drug resistance. Drug resistance against HIV drugs is an emerging problem worldwide. Once drug resistance develops, the efficacy of your treatment may decrease. Treatment failure can also occur. Resistance against one drug may also confer resistance against many other drugs used to treat HIV. This would eventually turn into a huge problem because you might run out of effective drugs against your infection. Drug-resistant strains can also infect others and confer the same resistance to them as well.
IS A CURE FOR HIV CLOSE?
While many effective treatments keep HIV in check and provide patients with improved quality of life, none of these medications effectively cure HIV. These medications need to be taken for the rest of a patient's life and quitting these drugs results in the remission of the disease process.
It is very difficult to develop an effective vaccine and a cure for HIV due to the deceptive nature of the virus. The virus hides in immune cells and continues to replicate and mutate to avoid confrontation with the immune system. These reservoirs are extremely hard to find and destroy because the virus lays dormant, and there is no way that an immune response could reach it in that state. HIV reservoirs are extremely problematic because even if there were a cure that could eliminate all HIV particles from the body, the virus could simply spring back to life from these reservoirs.
A cure for HIV may include either a functional cure or a sterilizing cure, which are nowhere near completion. However, researchers worldwide are looking into ways to achieve either one by attacking the HIV reservoir or its ability to replicate altogether. Monoclonal antibodies are promising as they are extracted from patients in which HIV can’t seem to suppress the immune system completely. Gene editing is also an option that researchers are looking into as a possible cure for HIV. The idea is to edit out the infected part of the DNA and render the virus useless.
Although without any definite success, researchers are striving hard to create a cure that works to eliminate this disease once and for all. Even though it might not come as quickly as we would like, researchers are hopeful that a definite cure for HIV is on the cards, and it might be coming soon.