More than 40 years have passed since the HIV virus – the virus that causes AIDS – was identified, and since then it has become one of the biggest challenges in modern medicine.
Today, people living with the virus can live long and healthy lives with the help of advanced drug treatment, and transmission is almost fully preventable. But one thing is still missing: A cure.
Now, scientists around the world are saying cautiously: We are closer than ever. According to them, it is no longer a question of whether there will be a cure – but how and when.
Why is HIV so hard to cure?
To understand the difficulty, one must understand the enemy. HIV is not an ordinary virus. Most viruses invade a cell, replicate – and then the immune system destroys them. HIV does something completely different: It integrates into the DNA of the immune cells themselves. In other words, the body is not just fighting the virus – it is fighting its own cells.
In addition, the virus replicates at an enormous speed and makes many mistakes in copying itself. These mistakes actually help it survive: Every small change creates a new variation that the immune system does not recognize.
The implication: While the immune system is learning to fight one version – another has already emerged.
The biggest problem is what scientists call a "viral reservoir." Some infected cells are inactive – they do not produce viruses, so the immune system and drugs do not recognize them. They simply remain in the body for years.
Once treatment is stopped – the virus returns. Therefore, current drugs succeed in controlling the disease but not eliminating it.
In the world, a few people have been documented whose virus disappeared from their bodies. All underwent a special bone marrow transplant – a dangerous procedure that replaces the entire immune system.
This proved an important principle: It is possible to completely get rid of the virus. But this is not a practical method for most patients – and so scientists are looking for a safer way to achieve the same result.
The New Strategy: Combining Methods
Researchers estimate there will not be a single "magic pill." The cure, if it comes, will be similar to combination treatment: Several approaches together. The goal is twofold: To expose the infected cells – and destroy them. This is the development path of the new mechanism that could remove HIV from the body:
1. Cause infected cells to self-destruct
New studies have found that some antiviral drugs can not only stop the virus – but also kill an infected cell. The problem: Not all cells respond. Now researchers are trying to understand what makes some cells resistant – in order to destroy them as well.
2. Nanoparticles that deliver genetic information
New technology uses tiny particles that deliver a "payload" into cells – for example, a protein that forces the virus to reveal itself. Once the cell shows a sign of being infected – the immune system can attack. The technology is similar to that used in mRNA vaccines.
3. Genetic engineering of the immune system
Another approach is to "strengthen" the immune cells themselves so they recognize the virus even when it changes. The idea: To create cells smarter than the virus, ones it cannot escape. Similar methods are already used in advanced cancer treatments.
4. Stop the virus – then attack
One new understanding is that the immune system struggles to hit a moving target. Therefore, drugs are first used to stop virus replication, then the immune system is precisely targeted at the active virus.
<br>Why is there optimism now?
In the last decade, enormous resources have been invested in research, and advances in genetic technologies, nanomedicine, and immunology have changed the picture.
Today, scientists already understand:
• Where the virus hides
• How it survives for years
• How it can be exposed
In the past, all this information was one big unknown.
It is important to emphasize: The cure is still not here. But existing treatment is very effective. A treated, non-infectious person can live an almost normal life expectancy. The real significance of the research is the future: Moving from a chronic disease to a disease that can be ended.
The fight against HIV has gone through three stages:
1. Deadly disease
2. Controlled chronic disease
3. Target for a cure
Scientists are not there yet, but for the first time, they know exactly where they are going. And as the researchers themselves say: We can already see the landing path.