Simplified layperson answer: I will interpret the question to mean a generally available cure for most HIV/AIDS patients.
Possibly, but it will be very challenging.
We have eliminated HIV/AIDS from a small number of people through rather drastic means, such as stem cell transplants after a person’s entire immune system was effectively lain to waste. We do not have the technology to generalize this procedure. As of today (12/26/2024), seven people have had the virus eliminated in this manner.
This extreme treatment is not likely generalizable.
Current highly active antiretroviral therapy (HAART or HART) is so effective that when it’s adhered to, patients can actually get to undetectable levels of viral load and die of old age. However, this is contingent on several factors:
- The HIV/AIDS patient must adhere strictly to treatment.
- Treatment must not be interrupted.
- The patient’s body must continue to tolerate treatment.
The main challenge here is kidney disease. We do not have good data on how to manage HAART well when patients have chronic kidney disease and progress towards dialysis.
A cure would be difficult because while our drugs can interfere with almost every step of the HIV/AIDS replication cycle, we do not have a good means to eliminate it after it writes itself into our DNA. HIV is a type of virus called a retrovirus – it is capable of having a copy of its RNA turned into DNA and inserted into human DNA.
We have no current good answer to this problem. Our current therapies can “lock it up” and keep the virus trapped in the cells, but we don’t seem to have a means to get it out once it’s in there.
In the chart below, we see the cycle and which drugs inhibit it. Crucially, by the time someone is detected as having HIV, step 4 has already happened. That means we can prevent integration with integrase inhibitors, but it’s already happened by the time someone is detectable. Judicious HAART therapy can prevent the cycle, but it cannot evict the virus that’s already settled down into our DNA and is chilling there.
Courtesy: Positively Aware
