A digital illustration depicting the concept of a functional HIV cure, with focus on immune system and viral suppression.

HIV Cure: Is a Functional Cure on the Horizon?

Elliot Brynn in Health & Wellness July 2025 • 4 min read.

"Exploring the Frontiers of HIV Remission: What a Functional Cure Means and the Challenges Ahead"

For decades, HIV has been a formidable adversary, but the landscape of treatment and research has dramatically shifted. Antiretroviral therapy (ART) has transformed HIV from a death sentence into a manageable chronic condition, allowing people to live long and healthy lives. However, ART requires lifelong commitment, and scientists and patients alike are now looking beyond mere management towards a functional cure.

A functional cure, in the context of HIV, means achieving long-term remission without the need for ongoing antiretroviral therapy. It's a state where the virus is either eliminated or suppressed to such low levels that it doesn't cause disease progression or transmission. This is different from a sterilizing cure, which would mean the complete eradication of the virus from the body.

This article examines the exciting developments in HIV research, the innovative strategies being investigated, and the complex challenges that must be overcome to achieve a functional cure. We'll explore the science behind these approaches, from shrinking the latent reservoir to boosting the immune system, and discuss what the future might hold for people living with HIV.

Understanding the Challenge: Why a Functional Cure Is So Difficult

A digital illustration depicting the concept of a functional HIV cure, with focus on immune system and viral suppression.

The primary hurdle in achieving a functional cure for HIV lies in the virus's ability to hide within the body. HIV establishes a latent reservoir, a collection of infected cells that remain dormant, primarily in immune cells. These cells are not actively replicating the virus, making them invisible to ART and, often, to the immune system.

When ART is stopped, the latent virus can reactivate, leading to a resurgence of the infection. This reactivation is the biggest obstacle. Scientists are exploring many different ways to achieve a functional cure, including methods to decrease the size of the latent reservoir, enhance the immune system, or teach the body to control the virus.

The Latent Reservoir: A hidden pool of dormant, infected cells that can reactivate.
Viral Reactivation: The process by which the latent virus becomes active, leading to a resurgence of the infection.
Immune System Limitations: Challenges in effectively targeting and eliminating infected cells.

Many different strategies are being investigated to tackle the latent reservoir. The goal is to either shrink it to a size where the virus rarely reactivates, or to train the immune system to control the virus if it does reactivate. Research is complex, with the goal of achieving a functional cure requires a multi-faceted approach.

The Future of HIV: Hope and Continued Research

The journey towards a functional cure for HIV is a complex one, but it's filled with hope and promise. Researchers are making significant progress, and with ongoing dedication and innovation, the dream of a life free from the daily burden of HIV treatment could soon become a reality. The efforts of researchers, coupled with the resilience of those living with HIV, are driving this essential work forward.

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.

This article is based on research published under:

DOI-LINK: 10.1038/s41577-018-0085-4, Alternate LINK

Title: Functional Cure Of Hiv: The Scale Of The Challenge

Subject: Energy Engineering and Power Technology

Journal: Nature Reviews Immunology

Publisher: Springer Science and Business Media LLC

Authors: Miles P. Davenport, David S. Khoury, Deborah Cromer, Sharon R. Lewin, Anthony D. Kelleher, Stephen J. Kent

Published: 2018-11-08

Everything You Need To Know

What is a functional cure for HIV, and how does it differ from a sterilizing cure?

A functional cure for HIV means achieving long-term remission without needing continuous antiretroviral therapy (ART). In this state, the virus is either suppressed to such low levels that it doesn't cause disease progression or transmission, or it may even be eliminated. This differs from a sterilizing cure, which would involve completely eradicating the virus from the body. The main focus is controlling the virus so that ART isn't necessary for a patient to live a healthy life. Unlike a sterilizing cure that aims to remove every trace of HIV, a functional cure is about managing the infection effectively.

Why is it so difficult to achieve a functional cure for HIV?

Achieving a functional cure is difficult primarily because HIV can hide within the body, forming a latent reservoir. This reservoir consists of infected cells that remain dormant, largely unaffected by antiretroviral therapy (ART) and, in many cases, undetected by the immune system. The biggest challenge lies in the potential viral reactivation from this latent reservoir, which can lead to a resurgence of the infection if ART is stopped. This is because ART is designed to target active replication and not latent cells.

What is the latent reservoir in HIV, and why is it a major obstacle to finding a cure?

The latent reservoir in HIV is a hidden pool of dormant, infected cells within the body, primarily in immune cells. These cells are not actively replicating the virus, making them invisible to antiretroviral therapy (ART) and often to the immune system. It's a major obstacle because, if ART is stopped, the latent virus can reactivate, leading to a resurgence of the infection. This reactivation is the biggest hurdle, making it difficult to achieve long-term remission.

What strategies are being explored to achieve a functional cure for HIV, and what are their goals?

Several strategies are being investigated to tackle the latent reservoir and achieve a functional cure. The goal is to either shrink the latent reservoir to a size where the virus rarely reactivates, or to train the immune system to control the virus if it does reactivate. Approaches include methods to decrease the size of the latent reservoir, enhance the immune system's ability to target and eliminate infected cells, or teach the body to control the virus itself. These strategies seek to manipulate or eliminate the latent reservoir to prevent viral rebound.

If Antiretroviral therapy (ART) can manage HIV, why the push for a functional cure?

While Antiretroviral therapy (ART) has transformed HIV into a manageable chronic condition, it requires lifelong commitment and can come with its own set of challenges, including potential side effects and the burden of daily medication. The push for a functional cure aims to go beyond mere management, offering the possibility of long-term remission without the need for ongoing ART. This would significantly improve the quality of life for people living with HIV, eliminating the need for continuous medication and reducing the risk of drug-related complications. Additionally, a functional cure could potentially reduce the risk of onward transmission, further contributing to the fight against the epidemic. This long-term solution eliminates the daily burden of HIV treatment.