In The Field

International AIDS Conference: Still hoping for a cure

Decades after AIDS first appeared, doctors are still hoping for a cure.

This week, Tony Fauci, head of the U.S. National Institute for Allergy and Infectious Disease, added his voice to that conversation with an opinion piece on CNN and a talk at a special session on the future of AIDS.

Fauci is saying a cure may be possible – for a few people – if doctors treat them very aggressively within days after infection. Under these conditions, it will be well-night imposible for the vast majority of AIDS patients to be cured. But the conversation about a cure has a broader significance, because it brings a dose of optimism among the painful and stark realities surrounding this disease.

Still, there’s a long way to go before such cures are possible, molecular biologist Robert Siliciano of the Johns Hopkins University School of Medicine in Baltimore, Maryland, told the meeting yesterday.

Siliciano said that drugs can indeed slash HIV down to almost undetectable levels in many people and called this the first step to a cure. But, he said, scientists must now tackle steps two and three by finding everywhere in the body that HIV can hide out after an individual becomes infected – the so-called “viral reservoirs” – and figuring out how to flush the virus out of those reservoirs so it can be attacked by drugs.

“It would be a mistake to say we’re one-third of the way there to finding a cure for HIV infection, because the second and third steps may prove much more difficult,” Siliciano said.

And, Siliciano added, the possiblity of a cure brings with it a responsiblity for researchers and drug companies: “What it means is that treatment failure is not inevitable,” Siliicano said. “[I]f we could develop forms of these drugs that could be taken for life without unacceptable toxicity, then it is, in principle, possible to offer everyone who is currently living with HIV infection the chance for a normal life.”


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