Challenges, progress and strategies in the search for a cure for HIV

The past three decades has seen a major transformation in the understanding and management of HIV infection. Effective combination antiretroviral therapy (cART) has transformed HIV from a universal death sentence to a chronic manageable disease. Current cART regimens are simpler - often only a single daily (combination) pill, but treatment must be taken life-long. Life expectancy of an HIV-infected person who receives effective cART, is now similar to a person without HIV1. The cost of long-term treatment is significant. There is now intense scientific interest in finding a cure for HIV infection or a way to allow patients to safely stop cART and remain healthy with the virus under control. A cure for HIV could either be a ‘sterilising cure’ – where there is no evidence of persistent HIV infection 2,3 or a‘functional cure’ where HIV is still present at low levels and health is maintained in the absence of cART2.