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by Loq 2603 days ago

    potentially decades away   
Would you be able to sketch, in a sentence or two, why we can be reasonably certain about cures being difficult. Is there a specific reason? Are you similarly pessimistic about a vaccine?
2 comments

Vaccines do well for diseases for which your natural immunity can protect you from them after you've created antibodies. HIV works the other way: the virus lets you create antibodies and then it wins the fight by hiding in your immune system and slowing turning the tables.

The virus also stay dormant within your cells, and it is not absolutely clear where, yet. Other viruses which do this (chickenpox, herpes, papillomavirus, ...) are not cleared from the body by the immune system either, but at least the immune system can control them as long as it is healthy enough.

This facts, of course, are no reason to be pessimistic about a cure/vaccine, just explains why it is taking that long. A cure might also pad the way to cure other diseases such as chickenpox and herpes, which may lead to complications later in life.

Among other reasons is that HIV is extremely bad at replicating itself without error. Which means, especially combined with the long-term nature of infection, a lot of genetic variation within a single person's viral ecology.

Generally, it's much easier to develop a vaccine for more stable viruses.

We might be able to target some sort of antigen on the virus that's highly conserved even with that mutation rate, but that's a big if.