Shock and Awe Against HIV

The HIV epidemic has caused some doctors to become more creative in their approach to fighting the disease. Along with the usual prevention-and-treatment approach, something new has emerged as a strategy for finding a cure for HIV, and it's due to the Berlin Patient. The story of the Berlin Patient is rather remarkable. An HIV-positive American living in Germany gets a bone marrow transplant to treat his leukemia, which treated not only the leukemia, but also the HIV. In fact, after two successful transplants, the HIV was eradicated from his system entirely. To this day, the Berlin Patient is believed to be the only person who has ever been cured of HIV infection.

While something as complex and risky as a bone marrow transplant is not practical for the tens of millions of people worldwide who have HIV, the interest it created has the HIV research community working in earnest to find a cure.

At this point, a functional cure is a more realistic goal. A functional cure is obtained when the viral load is reduced to a point where the immune system can easily handle it and keep it suppressed. Finding a functional cure will reduce the dependence on antiretroviral therapy (ART) drugs or completely eliminate the need for them entirely. Various other types of "cures" were attempted throughout the years, but none of them got close to doing much to eradicate HIV. The "Berlin Patient" bone marrow transplant worked because the bone marrow came from a donor who was genetically resistant to HIV – a very rare genetic mutation.

The HAART approach used highly-active antiretroviral therapy (HAART) to drive the HIV virus down to undetectable levels in the bloodstream, and was thought to be the first step on the path toward a cure, but a major flaw found this to be incorrect. While HAART did effectively fight the active virus, it does not kill the latent virus that resides in the cells. This is where the "shock and awe" approach comes in. Anti-latency drugs are introduced into the system in order to force the HIV virus to activate and attempt to replicate. Once the virus is out in the open, the infected cells die while HAART protects cells that are not yet infected.

More work is to be done on the "shock and awe" approach to see if it can be effective against HIV in the long-term; until then, the Berlin Patient isn't content with being the only person cured of HIV. Even he wants to see more money put into research toward an HIV cure. With the progress being made in treatments and therapy for HIV-positive patients, the scientific community believes that it's only a matter of time.

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