What is Human Immunodeficiency Virus (HIV-1)?

HIV-1 is a virus that attacks the immune system in humans. It targets CD4+ T cells (a type of immune cell) that are crucial for fighting off infections. If left untreated, the virus can impair the immune system’s ability to fight off other infections and diseases.

The graph above shows the relationship between the amount of virus (red line) and the numbers of CD4+ T cells (blue line) over time. During acute infection, virus levels are high until immune responses begin to develop. However, since HIV-1 mutates extremely rapidly, an ongoing struggle of control continues between the virus and the immune system.

What is cART?

Combination Antiretroviral Therapy (cART) is the standard of care therapeutic treatment for HIV-1 infection. It consists of a combination of drugs targeting steps in the replication cycle of the virus. However, since HIV-1 mutates so fast, one drug is currently not enough to manage the infection. Most patients take a combination of three drugs. If cART drugs are taken every day, it is possible to maintain very low virus levels and minimize the loss of immune cells.

Current HIV-1 Therapeutic Drugs

  • To maintain viral suppression, adherence to cART drugs is required daily.
  • Even when HIV-1 is fully suppressed by cART, some of it still remains in a dormant state, called the viral reservoir. Unfortunately, cART does not directly affect the viral reservoir. The reservoir is the source of virus when cART therapy is interrupted.
  • The lifetime cost of HIV-1 infection treatment management in the U.S. is estimated at over half a million dollars.
  • HIV-1 mutates so rapidly that therapies may need to be changed. This is especially important if treatment is interrupted.

Common Misconceptions

HIV-1 is still quite misunderstood throughout the world. Below are some common myths about the virus. Click on the underlined text for more information.

Myth: HIV can be spread through contact such as kissing, holding hands, or sharing utensils.

Fact: HIV is spread primarily through sexual contact, and through blood. HIV is not known to transmit from saliva, sweat, or tears. The virus can sometimes be spread through childbirth or breastfeeding, but this can be prevented with medicines. If a person has been taking antiretroviral drugs every day, the risk of spreading the virus is lower. HIV cannot be spread by mosquitoes.

Myth: HIV has stopped spreading.

Fact: While the rates of new HIV infections have declined over the last few decades, there are still millions of new cases of HIV every year.

Myth: Now that there are treatments for HIV, it is not a problem.

Fact: Medications have drastically improved and increased the lifespans of many HIV-infected people, but not everyone has access to that care. Nearly one quarter of HIV- infected people in the world still do not have access to the treatments that would save their lives. Without medications, HIV can quickly progress to AIDS.

Myth: HIV mostly impacts older people.

Fact: The largest proportion of new cases of HIV infection in the United States between 2013-2019 has been occurring in younger people betweem 25 and 34 years of age (CDC Statistics Slides).

Myth: HIV is no longer a problem in the U.S.

Fact: While some countries have higher rates of HIV infection, this virus can be found anywhere in the world. HIV can have an impact anywhere that there are people, including the U.S.