The prospects for a cure now look brighter because of technological and medical advances.
Toulon, France, September 26, 2011 — To this day, the "Berlin Patient" is believed to be the only person to ever be cured of HIV, and that cure was basically stumbled upon-a cure by serendipity, if you will. What was originally a transplant to treat HIV-related leukemia turned into a complete cure for HIV. It took many in the HIV research community by surprise and gave them hope that a more practical cure could eventually be found. That leads us to the following question: What type of cure would be more practical? A sterilizing cure-that is the complete eradication of HIV from the body-would be ideal, but may not be a realistic goal. Therefore, a functional cure-reducing the HIV viral load in the body to a level that keeps it in check permanently-seems to be more practical at this point.
The prospects for a cure now look brighter because of technological and medical advances. The proposed "cures" of the past failed in one way or another, primarily because there was a fatal flaw somewhere that failed to prevent the virus from replicating. Highly active antiretroviral therapy (HAART) is one such method used. Using a combination of different antiretroviral medications, these medications interacted with each other to stop the virus at various points of its life cycle. While it reduced the HIV in the body to undetectable levels, the flaw emerged when people stopped taking the drugs.
Once they stopped treatment, the virus began replicating again in earnest; it was able to do this because of HIV reservoirs, or pockets of cells within the body where HIV lies dormant during HAART. HIV can remain dormant in these reservoirs for decades-especially since the reservoirs have a half-life of over 70 years. Cracking these reservoirs and somehow eradicating the virus within is the key to finding a functional cure for HIV.
The Berlin Patient taught the HIV research community that looking into people with the CCR5 mutation in their T-cells. These people are the small percentage of humans in the world who are naturally resistant to HIV. Bone marrow from a person with the CCR5 mutation was used in the Berlin Patient transplant, which is why research into the mutation has so much upside. Replicating this mutation on a wider scale could be the key to finding a cure. Furthermore, developing an entirely different strategy to deal with cell-to-cell transmission of HIV within the body is also on the agenda. The current antiretroviral medications are very effective at stopping HIV transmission through the bloodstream from cell to cell, but direct cell-to-cell transmission is something entirely different.
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