curar aids

Towards a Functional Cure for HIV-AIDS

Diseases, Infectious Disease, Sexuality

It is amazing to think that 32 years ago, the first strange skin infections caused by the HIV virus started to appear, and 29 years ago, the Secretary of Health of the United States announced that a vaccine for the AIDS virus should be ready “within two years”.

Thirty years later, we are still waiting for that vaccine, or for an AIDS cure. (Either or both would be nice.) But for viral scientists, HIV has been much stronger and harder to manage than they had imagined.

Except for the development of the HIV “cocktail” treatment in the late 1990s, there has been little cause for celebration during this 32 year HIV/AIDS timeline. But recently, in the past two years or so, medical researchers have started to use the word “cure”, But not really “cure”. They use the term “functional cure”. (Sort of like “slightly pregnant”.) Let’s try to explain.

Many HIV researchers now believe that—despite billions of dollars of research—that a complete “cure” for HIV or AIDS will not happen in the next few years.  And that the best we can hope for now is a “functional cure”. That means, a person contracts the HIV virus, then begins retroviral treatment with three or more medications (the “cocktail”) but then stops the treatment some years later.

The people whose HIV count remains very low or undetectable for a long and indeterminate period despite stopping treatment are considered “functionally cured”.

Most people infected with HIV, when they stop their medication, suffer a big surge in their HIV virus count within a few weeks. But not everyone, and that was the point of a French research study published online March 14 in PLOS Pathogens.

Generally, people with HIV who start the cocktail are not supposed to stop it. They are to stay on it for life, or until a better treatment or a cure is found.  But like for anything else, some people don’t adhere to the recommended treatment. They stop it for many reasons…. either the drugs are too expensive, or inconvenient, or they get side effects …for many reasons, they stop the drugs.

The researchers at the Pasteur Institute in Paris described 14 patients who had a “functional cure”. They had been on the cocktail for an average of three years, but then they stopped it, and despite that, their HIV viral count remained exceptionally low or undetectable for an average seven years after stopping their cocktail.

The researchers felt that the key to their success was that all of these “lucky” 14 started their cocktails within 10 weeks of becoming HIV infected. The other important issue, a cautionary one, is that the researchers estimate that only up to 15% of people who start treatment would be able to stop it at some point, like these lucky 14, and enjoy this “functional cure”. The majority of people would need to go back on medication.

But still, this is a big deal, and HIV researchers are directing attention to how to increase the percentage of functional cures. But for now, the earlier the treatment, the better. If someone infected with the virus waits, the virus slowly damages the immune system, and begins to hibernate in many organs, including the brain and nervous system. So the longer the virus goes untreated, the more difficult it is to suppress completely.

This should give all of us who are sexually active and thus potentially at risk for HIV to get tested perhaps several times per year. So if an HIV negative person turns positive, starting a cocktail as soon as possible seems to be the wise move. And the more often you are tested, the sooner you will know if you turn positive.

Remember though, the HIV cocktail is potent and while treatment is much easier than it used to be, it is still no picnic. There are side effects. The best approach is to prevent HIV infection, and that means, always, have the safest sex that you can.

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See also in ProcuraMed:

*The history of HIV therapy “cocktails”




Esta postagem também está disponível em: Portuguese (Brazil)

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