11 June 2012

Why Antiretroviral Therapy Cannot Cure HIV Infection

Today, science, research, and technology have done so much when it comes to addressing the problems of humankind. It has invented so many things making life easier and more convenient. By just visiting a house, you can see a lot of instruments, tools, machines, and equipment that aid in the smooth flow of everyday life. Not only that, inventions and discoveries has helped various aspects of our lives. Health and medicine is one of those that benefited from science and technology. There are now drugs that can cure or prevent diseases such as heart attack, urinary tract infection, lung cancer, and many others. But there is still one pandemic that until now no one has discovered the drug that can cure it: HIV infection.

What is Human Immunodeficiency Virus or HIV?

The Human Immunodeficiency Virus or HIV is classified as a lentivirus. HIV causes the Acquired Immunodeficiency Syndrome or AIDS. It is a condition where the immune system of an individual starts to fail, which leads to opportunistic infections. One may be infected with HIV through the transfer of vaginal fluid, semen, breast milk, pre-ejaculate, or through the blood. HIV is present in these bodily fluids as virus in infected immune cells and as a free virus particle. There are four major ways of transferring the virus and these are through breast milk, use of contaminated needles, transmission from mother to child, and unsafe sex.

Today, there are many researches being done to study the virus and how to reverse or prevent its effect of failing the immune system. Many doctors and researchers are conducting experiments to find a way on how to cure this deadly virus. Currently, there are antiretroviral therapies being used to block HIV replication. But even if these antiretroviral therapies are efficacious the infection still persists. The reason for the persistence of HIV is due to the reservoir cells that are latently infected. This reservoir is stable and is established early. This is the main recognized cause of HIV persistence.

Reservoir of latently HIV-infected cells

The latent reservoir of HIV is best characterized in memory CD4+ T cells. There is also a possibility that the reservoir may exist in other cells such as the hematopoietic stem cells, macrophages, and within the brain microglia. When a patient is treated successfully with an antiretroviral therapy for many years or even a decade, it shows that there is actually no significant reduction in the size particularly of the latent reservoir. On the other hand, when the therapy is discontinued the relapse of viral replication is rapid.

With this kind of virus, there is a need for a life-long antiviral therapy. The problem is this kind of therapy is very prone to cumulative side effects and drug resistance. Another thing is it is a burden financially particularly in those regions where the epidemic is most prevalent.

So, the fact remains that until today there is still no cure against HIV. The promises of antiretroviral therapies apparently do not yield all the positive results expected. So, given the fact that you still need a life-long treatment an HIV infected individual cannot expect a normal life yet. What is needed to really treat the virus is to find a way on how to eradicate the reservoir of latently infected cells. If science and research cannot discover something to address this, then HIV will remain a deadly virus killing thousands and thousands of people around the world.

What is to be done to eradicate HIV?

Today, there is a need for a multidisciplinary and joint effort with the goal of achieving a long term functional cure that is drug free remissions in individuals infected with HIV. The other goal of this effort is to develop a prophylactic vaccine against the virus for those who are not yet infected.

Given the advances in technology today, a long period of investigation will still be necessary to finally discover this cure.

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