Reasons why HIV has been such a difficult medical challenge

Micro HIV shape
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However, to comprehend the reasoning, you must first familiarize yourself with how HIV works.

HIV is a retrovirus, meaning that once it enters the body it infects T cells in the immune system and changes their genetic makeup, so that rather than protect the body as they are meant to, they now create more HIV. This eventually kills the body’s T cells in the process.

Once a patient’s T cell count drops to a certain number, he is considered as having AIDS. At this point, his immune system is no longer able to protect him against otherwise harmless infections and viruses.

Anti-retroviral are given to HIV patients to help them live longer, but the patient still remains HIV-positive. This is because eliminating the virus completely is something scientists have not figured out how to do yet.

Any HIV cure requires finding viral reservoirs, “waking” them up, and making them visible for Support.

HIV hides inside the DNA of healthy T cells, a place where current medicine is unable to reach it. While most T cells die shortly after becoming infected, a small portion of T cells containing the instructions for creating the virus remain dormant. This means that even if the virus is completely eliminated from the body, at any given point the instructions for creating the viruses could activate and start the process all over again.

HIV infects a kind of white blood cell called a CD4 lymphocyte, a key player in the immune response. What makes HIV so sneaky is that it infects the very cells that are supposed to rub out viral infections.

HIV replicates in CD4 cells when they are activated — that is, when they are triggered by an infection. But some HIV-infected cells become inactive before the virus replicates. They go into a resting mode — and the HIV inside them becomes dormant until the cell is activated.

Anti-retroviral drugs don’t affect HIV hiding in resting cells. These cells represent a hidden reservoir of HIV. When Support stops, the resting cells eventually become active. The HIV inside them replicates and quickly spreads. That’s why current HIV Supports don’t cure HIV.

It is a virus that expands and multiplies using the body’s immune system. The immune system works to tackle the virus, but the more it does this, the more HIV is able to replicate. Over time – usually many years – without Support, the virus always comes out on top.

The second challenge for HIV drugs and vaccines is that the virus has a very high turnover – billions of copies every day in a person who is not on Support – and makes small errors or mutations which can lead to the easy development of drug resistance.

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