Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

Karine Dubé¹, Loreen Willenberg², Lynda Dee^{3

4

5

6}, Laurie Sylla^{6

7}, Jeff Taylor^{4

6

8

9

10}, Christopher Roebuck^{6

11

12}, David Palm^{6

10

13}, Danielle Campbell^{5

6

14}, Luke Newton¹, Hursch Patel¹, Kelly E Perry¹, John Kanazawa¹, Jo Gerrard¹⁵, Brandon Brown¹⁶, Parya Saberi¹⁷, John A Sauceda¹⁷, Michael J Peluso¹⁸

Affiliations

¹ UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
² Zephyr LTNP Foundation, Inc., Sacramento, CA, USA.
³ AIDS Action Baltimore, Baltimore, MD, USA.
⁴ amfAR Institute for HIV Cure Research Community Advisory Board (CAB), Palm Springs, CA, USA.
⁵ Delaney AIDS Research Enterprise (DARE) CAB, Baltimore,MD and Los, Angeles, CA, USA.
⁶ Martin Delaney Collaboratory CAB, Baltimore, MD; Seattle, WA; Palm Springs, CA; Ithaca, NY, Los Angeles, CA, USA.
⁷ DefeatHIV CAB, Seattle, WA, USA.
⁸ HIV + Aging Research Project - Palm Springs (HARP-PS), Palm Springs, CA, USA.
⁹ University of California AntiViral Research Center CAB, San Diego, CA, USA.
¹⁰ Collaboratory of AIDS Researchers for Eradication (CARE) CAB, Chapel Hill, USA.
¹¹ BEAT-HIV CAB, Philadelphia, PA, USA.
¹² Department of Science and Technology Studies, Cornell University, Ithaca, NY, USA.
¹³ Institute of Global Health and Infectious Diseases (IGHID), University of North Carolina at Chapel Hill, NC, USA.
¹⁴ Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA, UCLA, Los Angeles, CA, USA.
¹⁵ University of California Riverside School of Medicine, Riverside, CA, USA.
¹⁶ Center for Healthy Communities, Department of Social Medicine and Population Health, University of California Riverside School of Medicine, Riverside, CA, USA.
¹⁷ Division of Prevention Science, Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA.
¹⁸ Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA, USA.

PMID: 33251025
PMCID: PMC7646673
DOI: 10.1016/j.jve.2020.100017

Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

Karine Dubé et al. J Virus Erad. 2020.

. 2020 Oct 14;6(4):100017.

doi: 10.1016/j.jve.2020.100017. eCollection 2020 Nov.

Authors

Affiliations

¹ UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
² Zephyr LTNP Foundation, Inc., Sacramento, CA, USA.
³ AIDS Action Baltimore, Baltimore, MD, USA.
⁴ amfAR Institute for HIV Cure Research Community Advisory Board (CAB), Palm Springs, CA, USA.
⁵ Delaney AIDS Research Enterprise (DARE) CAB, Baltimore,MD and Los, Angeles, CA, USA.
⁶ Martin Delaney Collaboratory CAB, Baltimore, MD; Seattle, WA; Palm Springs, CA; Ithaca, NY, Los Angeles, CA, USA.
⁷ DefeatHIV CAB, Seattle, WA, USA.
⁸ HIV + Aging Research Project - Palm Springs (HARP-PS), Palm Springs, CA, USA.
⁹ University of California AntiViral Research Center CAB, San Diego, CA, USA.
¹⁰ Collaboratory of AIDS Researchers for Eradication (CARE) CAB, Chapel Hill, USA.
¹¹ BEAT-HIV CAB, Philadelphia, PA, USA.
¹² Department of Science and Technology Studies, Cornell University, Ithaca, NY, USA.
¹³ Institute of Global Health and Infectious Diseases (IGHID), University of North Carolina at Chapel Hill, NC, USA.
¹⁴ Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA, UCLA, Los Angeles, CA, USA.
¹⁵ University of California Riverside School of Medicine, Riverside, CA, USA.
¹⁶ Center for Healthy Communities, Department of Social Medicine and Population Health, University of California Riverside School of Medicine, Riverside, CA, USA.
¹⁷ Division of Prevention Science, Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA.
¹⁸ Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA, USA.

PMID: 33251025
PMCID: PMC7646673
DOI: 10.1016/j.jve.2020.100017

Abstract

For over a decade, the binary concepts of 'sterilizing' versus 'functional' cure have provided an organizing framework for the field of HIV cure-related research. In this article, we examine how the expression 'functional cure' is employed within the field, published literature, and community understanding of HIV cure research. In our synthesis of the different meanings attributed to 'functional cure' within contemporary biomedical discourse, we argue that employing the 'functional cure' terminology poses a series of problems. The expression itself is contradictory and inconsistently used across a wide array of HIV cure research initiatives. Further, the meaning and acceptability of 'functional cure' within communities of people living with and affected by HIV is highly variable. After drawing lessons from other fields, such as cancer and infectious hepatitis cure research, we summarize our considerations and propose alternative language that may more aptly describe the scientific objectives in question. We call for closer attention to language used to describe HIV cure-related research, and for continued, significant, and strategic engagement to ensure acceptable and more precise terminology.

Keywords: Community engagement; Control; Functional cure; HIV; HIV cure research; Immunity; Journal of virus eradication; Language; Suppression; Terminology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Cited by

The Importance of Social Engagement in the Development of an HIV Cure: A Systematic Review of Stakeholder Perspectives.
Noorman MAJ, de Wit JBF, Marcos TA, Stutterheim SE, Jonas KJ, den Daas C. Noorman MAJ, et al. AIDS Behav. 2023 Nov;27(11):3789-3812. doi: 10.1007/s10461-023-04095-z. Epub 2023 Jun 17. AIDS Behav. 2023. PMID: 37329470 Free PMC article. Review.
Toward a cure - Advancing HIV/AIDs treatment modalities beyond antiretroviral therapy: A Review.
Alum EU, Uti DE, Ugwu OP, Alum BN. Alum EU, et al. Medicine (Baltimore). 2024 Jul 5;103(27):e38768. doi: 10.1097/MD.0000000000038768. Medicine (Baltimore). 2024. PMID: 38968496 Free PMC article. Review.
The perceived impact of an HIV cure by people living with HIV and key populations vulnerable to HIV in the Netherlands: A qualitative study.
Romijnders KAGJ, de Groot L, Vervoort SCJM, Basten MGJ, van Welzen BJ, Kretzschmar ME, Reiss P, Davidovich U, Rozhnova G. Romijnders KAGJ, et al. J Virus Erad. 2022 Feb 25;8(1):100066. doi: 10.1016/j.jve.2022.100066. eCollection 2022 Mar. J Virus Erad. 2022. PMID: 35280938 Free PMC article.
Ethics of HIV cure research: an unfinished agenda.
Dubé K, Kanazawa J, Taylor J, Dee L, Jones N, Roebuck C, Sylla L, Louella M, Kosmyna J, Kelly D, Clanton O, Palm D, Campbell DM, Onaiwu MG, Patel H, Ndukwe S, Henley L, Johnson MO, Saberi P, Brown B, Sauceda JA, Sugarman J. Dubé K, et al. BMC Med Ethics. 2021 Jun 30;22(1):83. doi: 10.1186/s12910-021-00651-1. BMC Med Ethics. 2021. PMID: 34193141 Free PMC article. Review.
Recall and Appraisal of the Risks, Benefits, and Objectives of Interrupting HIV Treatment in an HIV Cure-Related Study.
Korolkova A, Ndukwe SO, Dee L, Deeks SG, Peluso MJ, Hoh R, Rodriguez A, Sugarman J, Rodriguez Garcia L, Dubé K, Sauceda JA. Korolkova A, et al. AIDS Behav. 2024 Dec;28(12):4136-4145. doi: 10.1007/s10461-024-04485-x. Epub 2024 Sep 17. AIDS Behav. 2024. PMID: 39287733

See all "Cited by" articles

References

1. MacLeod M., Clambey E., Kappler J., Marrack P. CD4 memory T cells: what are they and what can they do? Semin Immunol. 2009;21(2):53–61. - PMC - PubMed
1. Richman D.D., Margolis D.M., Delaney M., Greene W.C., Hazuda D., Pomerantz R.J. The challenge of finding a cure for HIV infection. Science. 2009;323(March):1304–1307. - PubMed
1. Deeks S.G., Lewin S.R., Ross A.L. International AIDS Society Global Scientific Strategy: Towards an HIV Cure 2016. Nat Med [Internet] 2016 Aug;22(6):839. http://www.ncbi.nlm.nih.gov/pubmed/27400264 [cited 2016 Oct 15] - PMC - PubMed
1. Newton L., Necochea R., Palm D. Revisiting the “sterilising cure” terminology: a call for more patient-centred perspectives on HIV cure-related research. J Virus Erad. 2019;5:e18–20. - PMC - PubMed
1. Sylla L., Evans D., Taylor J. If we build it, will they come? Perceptions of HIV cure-related research by people living with HIV in four U.S. Cities: a qualitative focus group study. AIDS Res Hum Retrovir. 2018;34(1):56–66. http://online.liebertpub.com/doi/10.1089/aid.2017.0178 Available from: - DOI - PMC - PubMed

Grants and funding

LinkOut - more resources

Full Text Sources
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

Affiliations

Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous