why is HIV/AIDS so hard to cure?
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1. HIV integrates its RNA (converted to DNA) into the host cells genome. As long as that cell lives you will have HIV. So you have to not only destroy all the viruses but also all of the cells infected, and any cells those cells divide into.
2. HIV mutates rapidly, it can become more resistant to antiviral medications and require higher doses and/or combinations with other drugs or entirely new drugs
3. HIV infects immune cells, specifically CD4+ T cells which are important for regulating parts of the immune system. Without them the immune system is weakened and will have a harder time clearing a virus.
HIV has been cured 3 times. It involves irradiating/killing the bone marrow, which produces immune cells and blood cells and also gets infected with HIV. Then transplanting donor bone marrow from someone with a mutation making them resistant to infection with HIV. It is incredibly dangerous as the new bone marrow produces a foreign immune system which can often decide your body is one big pathogen and attack all of your cells which is ultimately fatal. To help prevent that you must take drugs that weaken this new immune system. Meaning you are in a similar state to when you had HIV even though you are now cured. All 3 of the people cured of HIV also had leukemia which this cured as well, it would not be approved in anyone who does not have leukemia as it is too dangerous with not much benefit.
While not curable with drugs, HIV can be controlled to levels so low you test negative on HIV tests. People receiving HIV treatment can live almost completely normal lives.
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