Although for some HIV patients the current 1-pill-once-a-day ART regimen may seem desirable—especially for longtime HIV sufferers who may have had to take handfuls of pills years ago—relying on ART for a lifetime is not an ideal situation. “Some people just get weary of taking medication every day,” said Dr. Fauci, who also pointed out that side effects of ART can be toxic. He is hopeful that a subset of patients will eventually be able to discontinue ART completely and noted that those with the best chance of achieving long-term or permanent suppression are those who begin ART shortly after diagnosis.
Another potential avenue to a cure that is currently in development is a therapeutic vaccine, which is administered to an individual who has HIV in order to boost the immune system and slow the progression of the disease. A preventive vaccine does not yet exist, although scientists are working on one. Dr. Shapiro is hopeful that stepping up treatment to all individuals with HIV worldwide will lead to a cure. “There is scientific debate about whether we can ‘treat our way out of the epidemic,’ or treat enough people so that we break the cycle of transmission, and a few large studies are looking at this question right now,” he said. “It may take a combination of several interventions, [such as] prevention campaigns, community-based testing, linkage to care and treatment, et cetera, and it will certainly take a large funding commitment.”
So, the question now is, how far away is a cure? The “Countdown to a Cure for AIDS” initiative of the American Foundation for AIDS Research aims to have a cure by 2020, but Dr. Volberding estimates that the medical community is about a decade away from one. When asked when all HIV patients might be able to achieve a cure in the form of permanent or semi-permanent viral suppression, Dr. Fauci answered, “How long that will be, we don’t know, and how many people will be able to do that, we don’t know.”
Laurie Saloman, MS, is a health writer with more than 20 years of experience working for both consumer and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University. She lives in New Jersey with her family.
Centers for Disease Control and Prevention. About HIV/AIDS. CDC website. https://www.cdc.gov/hiv/basics/whatishiv.html. Updated January 25, 2017. Accessed April 3, 2017.