One topic at the 31st Conference on Retroviruses and Opportunistic Infections (CROI 2024) held in Denver this month was that resistance to antiretroviral therapy (ART) has become a public health problem for people living with HIV. Without a vaccine or a cure, these patients depend on treatments that suppress viremia by preventing the virus from replicating. They are lifelong treatments and, until new advances succeed in eradicating the virus from reservoirs, the only option available.
Curing HIV remains a dream for now, but it is clearly not a pipe dream. One of the challenges for developing a vaccine is that there is no natural immune response to model such a vaccine on. Over time, an untreated HIV infection will almost certainly kill its host. However, there is a group of elite controllers – people who, although they cannot eliminate the virus, manage to keep it in check.
Like Berlin patient Timothy Ray Brown before him, London patient Adam Castillejo, whose case was top story of the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), energized the HIV cure research field by his sheer existence. Curing HIV, Pablo Tebas told the audience at a themed discussion on curative strategies, “has been considered [for] a long time the holy grail.”
CYBERSPACE – Continuing improvements in HIV treatment and progress toward a cure notwithstanding, an effective vaccine will be necessary to gain the upper hand in the decades-long fight against the pandemic.
With Friday’s last-minute decision to move to an all-virtual format, the opening session of the 2020 Conference on Retroviruses and Opportunistic Infections (CROI) was certainly an unusual one. “We are in uncharted waters,” conference co-chair Sharon Hillier, Richard Sweet Professor of Reproductive Infectious Disease at the University of Pittsburgh School of Medicine, told the audience via livestream.