that providing HIV treatment for over 37 million people in the world (less than one and a half million are in the US) is NOT economically sustainable!
Most countries in Africa, South-East Asia, Eastern Europe, Latin America, and the Caribbean simply cannot afford to provide medicines for the people in their countries that are infected. Most infected individuals cannot afford to pay for HIV treatment. When you further consider that in many countries (including the US), a significant proportion of HIV patients are not taking their medicines and are not suppressed, new infections continue and expand the numbers in need of treatment. Prevention campaigns have not stopped new infections. We need a cure! But this virus is very clever and there are reasons we haven’t been able to cure it.
In the previous article on the immune system and HIV, I presented some reasons why the immune system doesn’t simply eliminate the virus. It is through the immune system that curable viral infections are eliminated (e.g. flu, cold, mononucleosis, chicken pox). We will review some of the reasons why HIV isn’t cured by the treatment, BUT there are some exceptions!
Elite Controllers
There is a small group of individuals who get infected by HIV yet don’t develop the disease. They appear to effectively control the infection where they don’t experience a decline in their T-lymphocytes, which are destroyed by HIV, and they may have no detectable virus in the blood.
They can remain in this state for years without ever having taken medicines. There are small amounts of HIV in the body that can be detected with special sensitive tests, but it appears their immune systems can keep it under control. These patients are called Long-Term Non-Progressors (LTNP) or Elite Controllers, reflecting the fact that they don’t experience HIV disease progression and are able to control the virus.
When I was working at Johns Hopkins School of Medicine 10 years ago, I found two of these patients in a community clinic. I referred them to my