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Can You Keep HIV Under Control Without Treatment?

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human immunodeficiency virus

HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. If not treated, HIV can lead to AIDS. In 2019, Blacks were found to be 8.1 times more likely to be diagnosed with HIV.

There are two ways that HIV patients’ bodies can keep the virus under control after they stop antiretroviral therapy, a new study led by Dr. Anthony Fauci, director of NIAID, and Tae-Wook Chun, chief of its HIV Immunovirology Section, shows.

The findings could point to ways to help people with HIV keep the virus in remission without having to keep taking medications that can have long-term side effects, according to researchers at the U.S. National Institute of Allergy and Infectious Diseases (NIAID).

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Side effects of HIV medications include:

  • Fatigue
  • Feeling queasy
  • Diarrhea
  • Headaches
  • Insomnia
  • Rashes
  • Pain, tingling, or numbness in your feet or hands
  • Dry mouth

The following long-term side effects may also occur as a result of HIV medication:

  • Fat redistribution
  • Higher cholesterol or triglyceride levels
  • High blood sugar
  • Liver damage
  • Loss of bone density
  • Weight gain
  • Mitochondria problems
  • A buildup of a cellular waste product (lactic acidosis)

RELATED: Nutrition Tips For Persons Living With HIV (Human Immunodeficiency Virus)

What the study shows

It included two adults with HIV who began antiretroviral therapy (ART) soon after being infected with the virus. They continued treatment for more than six years and successfully suppressed the virus.

They then joined a clinical trial and stopped taking ART under medical supervision. One patient was followed for four years and the other for more than five, with assessments every two to three weeks.

Researchers were looking for the timing and size of viral rebounds in each — that is, times when levels of HIV in their blood became detectable.

Patient 1

In one patient, viral suppression lasted nearly three and a half years, with occasional rebounds in virus counts. The other patient had nearly completed HIV suppression for close to four years, but then had a big surge when he was infected with a different HIV strain, a situation called “superinfection.”

In the first patient, researchers found high levels of HIV-specific immune cells called CD8+ T cells that can kill virus-infected cells.

Patient 2

The second patient had a weaker CD8+ T cell response against HIV, but a very strong neutralizing antibody response until the sudden viral rebound.

This suggests that different mechanisms were at work in each patient, the researchers said in an NIAID news release.

Neutralizing antibodies may have played a significant role in near-complete HIV suppression until the second patient was infected with a different strain of the virus, according to the study.

The research also shows that HIV superinfection is a potential cause of a sudden virological breakthrough in people with HIV who stop ART, especially when after a prolonged period of virus suppression.

RELATED: Improving The Lives Of HIV Patients

human immunodeficiency virus

How to prevent HIV superinfection

The same actions that place a non-infected person at risk of developing HIV are the same actions that place a person at risk of HIV superinfection.

As a result, you should do the following to prevent HIV superinfection:

  • Use condoms
  • Get tested
  • Be monogamous
  • Get vaccinated
  • Do not abuse alcohol or drugs or share needles
  • Do not douche (Douching removes some of the normal bacteria in the vagina that protects you from infection. This may increase your risk of getting HIV and other STIs)

Human Immunodeficiency Virus: Frequently Asked Questions

1. How long can an HIV-positive person live?

With proper medical care, including antiretroviral therapy (ART), people with HIV can live long, healthy lives—often with life expectancies similar to those without HIV. Starting treatment early and staying on it consistently is key to managing the virus and preventing complications.

2. What happens if you have HIV and don’t treat it?

If left untreated, HIV gradually weakens the immune system by destroying CD4 cells (a type of white blood cell that fights infection). Without treatment, HIV can progress to AIDS (Acquired Immunodeficiency Syndrome), the most advanced stage of the infection. At this stage, the immune system is severely compromised, increasing the risk of serious infections and cancers. Without treatment, most people with AIDS survive about 3 years or less.

3. How long can HIV go undetected without treatment?

HIV can go undetected for many years if a person doesn’t get tested. This is because early symptoms can be mild or mistaken for other illnesses. The virus can quietly damage the immune system for up to 8 to 10 years (or longer) without causing major symptoms. However, even without symptoms, the virus is active and can be transmitted to others.

4. Is it possible to sleep with an HIV-positive person and not be infected?

Yes, it is possible—especially when the HIV-positive person is on effective treatment and has an undetectable viral load. This concept is known as U=U: Undetectable = Untransmittable. When someone is consistently taking ART and maintains an undetectable viral load, they cannot sexually transmit HIV to their partner. Additionally, using condoms and/or PrEP (pre-exposure prophylaxis) provides further protection for HIV-negative individuals.

 

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