Shock and kill
One method being explored is ‘shock and kill’. The idea is to wake up dormant CD4 T cells with HIV hiding in them. Once they become reactivated, the body can recognise and eliminate them.
Of course, the main question is: where are these dormant CD4 T cells and how do you wake them up?
We now know that they hide in many places in the body, like the intestines, lymph nodes and even the brain. So a method will have to be found that can reach all these places. This method must also reactivate all the dormant cells so that they can all be eliminated.
This is a simplified explanation. Of course, the reality is much more complicated. Researchers repeatedly encounter problems when applying this technique. For example, not all medicines can reach the dormant cells in the brain because your body has extra protection for this area (the blood-brain barrier). Additionally, it has not yet been possible to wake up all dormant CD4 cells that have HIV.
Another possible method is to use CRISPR to make the HIV hiding in the dormant CD4 cells harmless. This is a technique that allows pieces of DNA to be cut out. So this technique can be used to remove potentially harmful pieces of DNA.
In HIV cure research, a form of CRISPR protein is used: CRISPR-cas9. In this case, to cut the HIV DNA out of the CD4 T cells.
One problem with the CRISPR-cas9 method is that the technique is not yet precise enough to be used safely in human beings. There is a risk that too much or too little will be cut out of the DNA by accident. This can have major consequences; the functioning of the immune system is one of them.