Surreal illustration of medical technologies eradicating HIV.

Functional HIV Cure: The Next Frontier in HIV Treatment

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Kai Mendoza in Health & Wellness December 2025 • 5 min read.

"Discover the latest research and strategies to achieve long-term HIV remission without medication."


For decades, antiretroviral therapy (ART) has been the cornerstone of HIV treatment, effectively suppressing the virus and allowing individuals to live long and healthy lives. However, ART is not a cure. It requires lifelong adherence and can come with significant side effects and costs. That’s why researchers are now exploring a variety of innovative interventions aimed at achieving what’s known as a “functional cure” – a state of sustained remission where the virus is controlled without the need for ongoing medication.

A functional cure represents a paradigm shift in HIV treatment, offering the promise of ART-free periods, reduced side effects, and decreased costs. But what exactly does it take to achieve this ambitious goal? A groundbreaking study published in Nature Reviews Immunology delves into the challenges and potential strategies for inducing long-term HIV remission. By using mathematical modeling, the researchers provide insights into the scale of the challenge and the efficacy required for different approaches.

This article unpacks the key findings of the study, exploring the most promising avenues for achieving a functional HIV cure. We will examine the strategies being explored, the hurdles that need to be overcome, and the exciting possibilities that lie on the horizon. Whether you're a healthcare professional, a person living with HIV, or simply interested in the future of medicine, this is your guide to understanding the next frontier in HIV treatment.

What Does It Take to Achieve a Functional Cure?

Surreal illustration of medical technologies eradicating HIV.

The study highlights that achieving a functional HIV cure is not a simple task. The virus has a remarkable ability to hide within the body, forming a “latent reservoir” of infected cells that can reactivate and cause the virus to rebound if ART is stopped. Therefore, any successful intervention must address this latent reservoir, either by eliminating it, shrinking it, or controlling its reactivation.

The researchers used mathematical modeling to predict the efficacy required for different approaches to induce durable ART-free remissions. The results are sobering: for many strategies, over 99.9% efficacy is needed to achieve long-term remission. This means that current interventions, which often have much lower efficacy rates, need significant improvement to achieve a lasting functional cure.

  • Reducing the Latent Reservoir: This approach aims to eliminate or shrink the pool of latently infected cells. Strategies include:
    • Small-molecule stimulation of latently infected cells to make them visible to the immune system.
    • Targeting and destroying infected cell subsets.
  • Improving Immune Responses: Enhancing the body's natural ability to control the virus. Strategies include:
    • Active immunotherapy (vaccination) to boost the immune system.
    • Passive immunotherapy (infusion of antibodies) to directly target the virus or infected cells.
  • Gene Therapy: Modifying cells to make them resistant to HIV infection or to directly target the latent provirus. Strategies include:
    • Using CRISPR-Cas9 technology to cleave and inactivate HIV proviral DNA.
While each approach holds promise, they also face unique challenges. Eliminating the latent reservoir completely is incredibly difficult due to the virus's ability to hide and the difficulty of targeting all infected cells. Improving immune responses requires overcoming the virus's ability to evade the immune system. Gene therapy faces hurdles in delivering the therapy to enough cells and ensuring long-term efficacy.

The Path Forward: Combining Strategies and Overcoming Challenges

The study emphasizes that a combination of strategies will likely be needed to achieve a functional HIV cure. By combining approaches that target different aspects of the virus and the immune system, researchers hope to achieve the level of efficacy needed for long-term remission. This might involve combining therapies that reduce the latent reservoir with those that boost immune responses or make cells resistant to infection. While the challenges are significant, the potential benefits of a functional HIV cure are enormous. Continued research and innovation are essential to translate these promising strategies into reality and bring hope to millions of people living with HIV.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

1

What does it mean to have a 'functional cure' for HIV?

A functional HIV cure refers to achieving long-term HIV remission without needing ongoing medication like antiretroviral therapy (ART). It means the virus is controlled by the body's immune system, or through therapeutic interventions, even after stopping ART. This differs from a sterilizing cure, where the virus is completely eliminated from the body. A functional cure aims to provide the benefits of viral suppression without the burden of daily medication, side effects and cost.

2

Why is the 'latent reservoir' such a big deal in HIV treatment?

The latent reservoir is significant because it represents a major obstacle to achieving a functional HIV cure. It consists of infected cells where the virus lies dormant and undetectable by the immune system or antiretroviral drugs. If ART is stopped, these cells can reactivate and cause the virus to rebound, thus preventing long-term remission. Therefore, any successful strategy for a functional cure must address this latent reservoir, either by eliminating it, shrinking it, or preventing its reactivation.

3

What are some of the main strategies scientists are using to try and achieve a functional HIV cure?

Several strategies are being explored to achieve a functional HIV cure. These include: reducing the latent reservoir through methods like stimulating latently infected cells to make them visible to the immune system or targeting and destroying infected cell subsets. Improving immune responses via active immunotherapy (vaccination) or passive immunotherapy (infusion of antibodies) to directly target the virus or infected cells. Gene therapy using techniques like CRISPR-Cas9 to modify cells to resist HIV or directly target the latent provirus.

4

What are the biggest roadblocks preventing researchers from achieving a functional HIV cure?

Achieving a functional HIV cure poses several challenges. Eliminating the latent reservoir is difficult because the virus can hide effectively within the body. Enhancing immune responses requires overcoming the virus's ability to evade the immune system. Gene therapy faces hurdles in delivering the therapy to enough cells and ensuring long-term efficacy. Mathematical modeling suggests that many strategies need over 99.9% efficacy to achieve long-term remission, indicating that current interventions need significant improvement.

5

Why is it so important to combine different treatment strategies when trying to cure HIV?

Combination strategies are vital because no single approach has proven effective enough to achieve a functional HIV cure on its own. By combining strategies that target different aspects of the virus and the immune system, researchers aim to achieve the high level of efficacy needed for long-term remission. This could involve combining therapies that reduce the latent reservoir with those that boost immune responses or make cells resistant to infection. The synergy of multiple approaches may overcome the limitations of individual strategies.

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