Finding a Cure

A report on Sarah Fidler’s presentation “Approaches towards a cure for HIV” 

Sarah Fidler opened her lecture on HIV cure by provocatively asking – with the advances in drug therapy in the last decade, do we even need a cure? Of course with the financial costs of ARVs in addition to the potential impacts of ageing with HIV, a cure is ideal. 

The sterilising cure, used 9 years ago in the Berlin patient, has been thus far unreproducible. Redefining our expectations is an important first step to recognise the potential for products in the pipeline. Aiming therefore for a “functional cure”, one with a very low sustained viral load, could be achievable. This would allow for host control of viral replication without continued treatment, immune function restored, as well as stabilised, HIV-induced inflammation reduced, and very low risk of transmission to others. 

Interestingly, many of the strategies are similar to cancer research: modulating host immunity with vaccines or broadly neutralising antibodies (Bnabs) to target the virus; or a ‘shock and kill’ method which would reactivate HIV replication and then apply intense therapy, including immune modulators. Studies, such as RIVER, have shown some progress, however there is nothing imminently on the horizon. Subsequent presentations explored the particulars of these strategies. 

Clinically this is not going to change practice just yet. As we know, there is a healthy amount of speculation and conspiracy theories as to HIV cure, fuelled largely by the early days of HIV. Being aware and well versed in the science is yet another way to positively engage with our clients and offer guidance on the information they will inevitably be looking up outside our rooms. 

Author bio: 
Ian is currently a PHO (Registrar) at Cairns Sexual Health Service and a GP Registrar. He has a keen interest in holistic health, including the implementation of change on the system level. Ian has a background in education, public health, and leadership, having completed a Master of Public Policy at Simon Fraser University and courses in Medical Leadership at UQ. His interests expand to global health and health equity, and consequently he has been involved in health projects overseas.