HIV/AIDS is such that, once a while, there must be a return to its mystery. This is one of such. Originally posed in Quora as “Why is there no cure for HIV yet? Why is killing the virus so difficult, despite the technological advances we have?”, this 2015 response seems to be still interesting even with the prospects of genetic-editing approach towards a final cure for HIV that has been reported from Temple University in the US in 2017. The answer goes as follows:
By Kok Kuan Tan
The funny thing is we CAN cure HIV. Except there is one big caveat: you have to live to 120 years old! Let me explain. We currently have a lot of medicines used to treat HIV. They work in a variety of ways. Some block the HIV virus from entering the cell. Some stop the HIV virus from copying itself. Some block the HIV virus from joining with our cell’s DNA. All these things achieve one common goal. They interrupt the HIV life cycle so that it cannot reproduce and infect other cells. Our immune system then comes in and kills whatever virus is left floating about. So with the current medicines we have, we can actually kill the HIV virus. So why is HIV still incurable?
This is because during the first few weeks when a person is infected with HIV, a lot of the virus goes into hiding in many different cells in the body. This is called the infection reservoir. The problem is when the HIV is in hiding, the medicines cannot get to it to kill it. So even though the medicines we have can eradicate HIV floating in the blood, more HIV viruses will then come out of their hiding place to keep the infection going.
Some very smart mathematicians calculated that if a person gets infected with HIV and starts taking the medicines when he is 30 years old, all of the virus would have come out of hiding and get killed when he reaches 120 years old. So effectively by then, this person will be cured of HIV. So the trick to curing HIV is really not how to kill the virus (we already know how to do that), the trick is to lure the virus out of their hiding place. In medical circles, this is called the “kick and kill” approach. We kick the HIV out of their hiding places and then kill them.
During the 20th International AIDS Conference held in 2014, a paper was presented on an anti-cancer drug that seemed to be able to kick the HIV out of its hiding place! Studies are still going on but we remain hopeful. Also hopefully we can find even more medicines that can kick the HIV out of hiding. I heard of a company studying some bee venom that can also do it but I have yet to see any detailed reports.
Meanwhile, please remember that although HIV cannot be cured, it can be controlled very well. People infected with HIV live normal life spans. In fact they live very healthy and productive lives.
The author works with Dr. Tan & Partners, the Singapore based online medical consultants at the time of writing