By: Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center
It seems as if every few months, a new headline comes across the news telling us about a new HIV discovery. Our hopes go up and down depending on who is saying what. So, why no cure for HIV? We all want a cure and still don’t have one! 😱What is going on?
Researchers in medicine and public health are making strides:
- Mother-to-child transmission is rare.
- We have antiretroviral (ARV) drugs that can lead to U=U.
- Syringe exchanges are working.
- PrEP is available to prevent people from getting HIV from sex or injection drug use.
These have been great milestones—still, no cure but many, many advances.
New research has opened the door to a new approach.
Recently, there’s been a new understanding of what an HIV cure would look like. A cure for HIV may not be to “shock it and kill it,” but what’s called a “functional cure.” We refer to it as “Block- and-Lock.” ✋🏾🔒
But before we get into Block-and-Lock, we need to discuss “Elite Controllers.”
Elite Controllers are a tiny group of people – about .5 % of all people living with HIV. These are people living with HIV, and their bodies somehow suppress the virus without needing treatment. HIV in their bodies is latent – think: asleep 😴and unbothered.
Though HIV is still inside their bodies, they have undetectable levels of the virus in their bloodstreams without taking meds. It’s more of a natural response in their immune systems. This doesn’t mean you should go natural and stop taking your meds. Most people living with HIV need to take meds to stay healthy.
Knowing about these Elite Controllers inches us closer to learning about a cure.
To better understand the Elite Controllers, let’s discuss what happens when HIV enters most bodies. Once inside the body, HIV finds a host cell (your t-cells), hijacks it, and eventually destroys it. Then it takes over and starts to make copies of itself, spreading a bunch of infected cells into the body.
The main job of any virus, including HIV, is to replicate more and more. HIV meds stop HIV from making more copies. This treatment is called antiretroviral therapy or ARV. This approach has worked wonders and saved millions of lives. Most people taking ARVs can reach undetectable status and live long, healthy lives. 🙌🏾
However, if med use stops, HIV starts to replicate. That means, for most people (not elite controllers), taking meds is a lifelong journey.
The Block-and-Lock Concept
The Block-and-Lock idea is to try and mimic what happens within an Elite Controller’s body as a way of controlling viruses. This new approach would find the virus, shut off its ability to replicate, and then lock it away.✋🏾🔒 It would basically put the virus in a coma, and the virus wouldn’t be able to make copies, period. The virus wouldn’t even be able make copies even when medication use stops with the Block-and-Lock strategy. HIV would still be in the body but totally undetectable.
Why no cure for HIV? Dramatic progress is being made, but there are still challenges ahead.
The medical community is looking into the Block-and-Lock✋🏾🔒 idea. Researchers are looking for funding to do clinical trials. If the trials go well, then it will need to get FDA approval. And finally, companies will have to produce the medicine. But, there’s a lot of excitement in the healthcare industry about this new approach.
Currently, there is a 5-year initiative that includes a dozen institutions worldwide, led by researchers from Gladstone, Scripps Research Florida, and Weill Cornell Medicine. And many, many institutes are aggressively pursuing a broad range of research that could one day help provide a cure for HIV.
Many people currently living with HIV are anxious for a cure. If you are living with HIV and worried about your future, you could benefit by joining a peer support group like Positive Peers.
Positive Peers is a private app that allows peers to connect 24/7 to other young people living with HIV–people with similar experiences and concerns, providing each other with encouragement, comfort, and advice. It's a safe place for to learn about your diagnosis, rock your treatment, and dream about your future.
Come join our private, stigma-free, supportive community.
Health management tools with medication & appointment reminders.
Social networking in a community conversation & private chats.