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A commonly used anti-parasite drug wakes up the virus from a dormant state in people with HIV. This was discovered by scientists at Erasmus MC (Medical Centre) in the first study to test this drug in people living with HIV. “We’re still a long way from a cure.” 
 
The drug in question is pyrimethamine, which is used to treat infectious diseases such as toxoplasmosis. Treatment with pyrimethamine wakes up the virus from its dormant state, according to internist-infectiologist Henrieke Prins and molecular virologists Raquel Crespo and Cynthia Lungu.  
 

The research project is called SPIRAL and focuses primarily on women in sub-Saharan Africa. The project is investigating how to strengthen the immune system of people with HIV. And how to wake up the dormant CD4 cells with HIV in the HIV reservoir and remove the HIV.
 
This international project includes people with HIV, scientists and medical specialists from the Netherlands, South Africa, Zambia and Uganda. They are collaborating with pharmaceutical companies in their search for an effective, acceptable HIV cure for everyone in the world.
 

Lenacapavir is a new type of treatment that can be used in people who have become resistant to multiple other types of anti-HIV drugs. It is initially given in pill form, later as an injection that you only need to get once every six months. Unfortunately, people with HIV who use this medication still have to take other antiretroviral drugs, so these injections do not completely free you from pills.
 
In 2024, Lenacapavir proves to be effective as PrEP (Pre-Exposure Prophylaxis), an ideal solution for anyone who wants to protect themselves against HIV.
 

A Dutch research team asks 20 people with HIV if they would be willing to participate in HIV cure research in the future. Most of them would be, but they have serious concerns about stopping with anti-HIV drugs.
 
Logically, stopping with antiretroviral drugs is an important part of HIV cure research. But it does raise ethical questions, both for researchers and for people with HIV.
 
Internationally, there have been several studies of this kind, some of them more extensive. For people with HIV, there is an obstacle to participating in HIV cure research. They ask themselves, “Would I dare to stop taking life-saving anti-HIV drugs? What if my viral load shoots up again? What if my CD4 cells decrease? What if I develop opportunistic infections? What if I die because I am no longer taking my antiretrovirals?”
 
These are all questions that researchers, doctors and people with HIV will have to answer if HIV cure research is to be tested more extensively on human beings.
 

In 2017, an unknown woman in New York underwent a stem cell transplant to treat leukaemia, a deadly form of blood cancer. Fourteen months later, she stopped taking anti-HIV drugs. 
 
Her stem cell transplant was special because stem cells from someone who was immune to HIV were supplemented with stem cells from her sister (who was not immune to HIV). The reason was that the donor who was immune to HIV was not a good genetic match for her. The good news is, that in this case, the technique worked.
 

“We have found a way to very selectively trigger HIV-infected cells to self-destruct,” explains researcher Dr Shringar Rao from Erasmus MC (Medical Centre). 
 
“We activate a mechanism in the infected cell that causes it to self-destruct,” says Rao. “The advantage of our method is that we do not depend on the weakened immune system of people with HIV to kill the virus.”
 
“The next logical step would be to test DDX3 inhibitors in people with HIV. That is not yet possible, because these substances have not yet been approved for use in patients. Of course, we also want to investigate which other substances have the same effect and whether we can make combinations. The ultimate goal is to eradicate the dormant virus,” says research leader Dr Tokameh Mahmoudi.
 

Antibodies are the real detectives of the immune system. They track down bacteria and viruses and eliminate them. They are made of a protein and have a shape similar to the capital letter ‘Y’. They are able to specialise. The first HIV tests were based on antibodies that specialised in eradicating HIV. If you tested positive, it meant you had HIV antibodies.
 
Broadly Neutralising Antibodies (bNAbs) were discovered in 1990. They are a type of super HIV antibody that can detect and eliminate many different HIV mutations. Approximately 25% of all people with HIV have small amounts of these superheroes.
 
Since 2016, a great deal of research has been conducted into bNAbs, and researchers believe that genetically modified bNAbs are likely to be a very good addition to HIV treatment. 
 

Loreen Willenberg is an ‘elite controller’ from California, USA. An elite controller is someone whose body suppresses HIV without treatment. Approximately 0.5% of people with HIV are ‘elite controllers’.
 
Willenberg has had HIV since 1992 and has never taken an anti-HIV drug. Research now shows that Willenberg no longer has any intact HIV DNA. In practical terms, this means that her HIV can never multiply again.
 
In 2021, a similar ‘miracle’ is observed in a woman from Argentina. She wishes to remain anonymous and is referred to as ‘The Esperanza Patient’, after her place of residence.
 

Finally, no more daily pills — instead, two injections with HIV medication every two months. That is the benefit of injectables. Since 2021, these injections have also been available in Dutch hospitals and are covered by health insurance. For many people, the injections are a big improvement.

Research by the Dutch HIV Association shows that many people with HIV would only switch if the injectables work for six months.

NL4Cure is a collaboration between Dutch scientists, the HIV Association, HIV consultants and practitioners, the HIV Monitoring Foundation and the Aidsfonds. The aim is to cure HIV.
 
The research agenda has four cornerstones:

Collaboration between researchers, doctors and people living with HIV is vital for the development of an HIV cure. An example of this is the use of the word ‘cure’ when referring to the suppression of HIV without treatment.
 
Researchers talked about ‘functional cure’, while people with HIV only use the word cure when the virus has completely been eradicated from their bodies This kind of miscommunication should really be avoided’. So the term ‘functional cure’ is now being phased out.

In 2013, Marc Franke from Düsseldorf underwent a stem cell transplant for leukaemia, a deadly blood cancer. But he did not dare to stop taking anti-HIV drugs until 2018. In 2019, he was found to be HIV-free. In 2024, his doctors declared him cured of HIV.
 
Adam Castillejo from London received a stem cell transplant for Hodgkin's disease, a cancer of the lymph nodes. Sixteen months after the transplant, he stopped taking his HIV medication.
 
The stem cells were harvested from someone who is immune to HIV. Would you like to know more about this?  Then go to our page about cure. 

 

It has finally been proved that people with a low viral load can no longer transmit the virus. A global campaign called U=U (Undetectable equals Untransmissible) is launched. In the Netherlands, the campaign is called N=N (not detectable equals not transmissible).
 
Initially, less than 200 virus copies are considered the threshold, but in the summer of 2023, the World Health Organisation sets that threshold at less than 1,000 virus particles. 
 
This is good news for anyone with HIV who takes their anti-HIV drugs consistently. The message that they are no longer dangerous to other people is liberating.
 

At a conference in Paris, the third child to suppress the virus after treatment with anti-HIV drugs is described. A nine-year-old South African child born with HIV has not taken antiretrovirals for over eight years. The child’s body appears to be suppressing the virus on its own.
 
Although rare, researchers believe that starting HIV treatment on time means the HIV reservoir of dormant CD4 cells with HIV remains small, making the body better able to defend itself against HIV.
 
 

If people who have just been infected start HIV treatment immediately, how does this affect the HIV virus? That is the main question the NOVA study in the Netherlands hopes to answer. Two HIV research centres and seven HIV treatment centres are participating in this study.
 
Is it true that if you start taking anti-HIV drugs immediately, the HIV reservoir of dormant CD4 cells with HIV remains small? And if you give people immunotherapy that strengthens their resistance, would these people be able to control their HIV for a longer period of time (or forever) without antiretrovirals? 
 
People participating in the study are monitored intensively for a longer period of time.
 

Cities have an important role to play in reducing HIV. After all, cities are the ideal place for a virus to spread, if only because it’s where many people live, work and have fun together. 
 
Originally, this initiative started with 27 cities, but now over 350 cities across all continents are participating. Cities exchange ideas to help reduce the number of new HIV infections. Getting people tested, starting them straight away on HIV treatment and using PrEP (Pre-Exposure Prophylaxis) are examples of good methods for doing this.
 

CRISPR gene techniques are often explained as a way to cut DNA with genetic scissors. Researchers in Osaka, Japan, found out how to do it in 1987. This technique allows the DNA of all living organisms to be modified, so that includes viruses and human beings.
 
In 2012, research teams developed a way to use the protein ‘cas9’ to make even more precise cuts and remove or add genes. Because HIV copies itself in the DNA of the CD4 cells it has infected, the hope is that the CRISPR-cas9 technique can be used to cut HIV out of the DNA.
 

After a long search through medical records, a French research team finds 14 people who have stopped taking their anti-HIV drugs and are keeping the virus under control without HIV treatment. These people were given antiretrovirals fairly soon after their HIV diagnosis and, for various reasons, stopped taking them after a few years. 
 
Medical examinations show that these people do not have any special genetic characteristics that inhibit HIV. On the contrary, most of them are genetically more susceptible to HIV. This suggests that the few years that they did take the antiretroviral drugs helped their bodies to suppress HIV themselves.
 
Scientists suspect that between 5 and 15% of people who start HIV therapy within six months of their HIV infection, and continue on it for a few years, may be able to control the virus themselves for a longer period of time. 
 

Having HIV treatment to prevent HIV infection may sound laughable, but it works. PrEP (Pre-Exposure Prophylaxis) is very effective and allows people who are afraid of contracting HIV to better protect themselves. 
 
In Europe, it will take until 2016 before PrEP is approved. In the Netherlands, the main problem is the cost. Truvada used as PrEP costs around 600 euros a month, but after the patent expires in 2017, the price drops significantly. Now, you pay less than 20 euros for generic PrEP.
 

Timothy Ray Brown is the first person ever to be cured of HIV. Brown has leukaemia, a deadly blood cancer, for which he is treated in a Berlin hospital in 2006. He receives a stem cell transplant, but with stem cells from someone who is naturally immune to HIV. 
 
It is not until 2010 that Brown speaks publicly about his cure. He says that the stem cell transplant was really tough, but he is glad that his doctors are able to prove that HIV can be cured. 
 
Unfortunately, the leukaemia returns and Brown dies in 2020 at the age of 54. 
 

The fear of passing HIV on to someone else has always been one of the biggest side effects of HIV, both for yourself and for others. A group of Swiss doctors and researchers test the theory that if you have little or no virus in your blood, you cannot pass it on. They conclude that this is indeed the case. 
 
They write that, with a number of caveats, people with very little virus in their blood cannot transmit it. HIV activists are relieved, but scientists, doctors and especially policymakers are furious. They fear that people with HIV will get careless and that the pandemic will flare up again.
 
It is not until 2018, after extensive research on tens of thousands of people, that the theory proves to be true. If you have a viral load of less than 1000 virus copies per millilitre of blood, you cannot transmit the virus.
 

In an HIV vaccination study involving 3,000 volunteers from North and South America, the Caribbean and Australia, the vaccine appears not to work. In fact, people who receive the vaccine are more likely to become infected with HIV.
 
The first volunteer signs up in 2004, and people are still registering in 2007 when the experiment is abruptly shut down. 
 

A study which looks into the consequences of temporarily stopping with your HIV treatment (‘pill holiday’) shows that people who temporarily stop taking their antiretrovirals are more bothered by fatigue and pain, and that their mental health deteriorates, making them less sociable.
 
In addition to these adverse effects on your health, you may be running the risk of becoming partially or wholly resistant to an entire family of antiretroviral drugs, reducing your treatment options.
 
Approximately 5,500 people from a number of Western countries participated in this SMART study. 
 

Five years after the introduction of combination therapy, it becomes clear that when people stop taking certain anti-HIV drugs, they become resistant to the entire group of antiretroviral drugs that work in a similar way. So it is really important that people take their medication as consistently as possible. 
 
In the past, a ‘pill holiday’ was sometimes prescribed if the side effects were too severe, now doctors must find other ways to reduce the side effects. Fortunately, antiretrovirals are being tailored more precisely to each other, and an increasing number of anti-HIV drugs are becoming available, allowing doctors to choose from a wider range to put together the best possible combination.
 
Nevertheless, even today (2025), many people still suffer from side effects caused by HIV treatment. Never hesitate to raise this issue with the doctor treating you. Severe side effects from medication can often be prevented.
 

UNAIDS (Joint United Nations Programme on HIV/AIDS), the World Health Organisation and five drug manufacturers form an alliance to accelerate the availability of anti-HIV drugs in developing countries. 
 
Most people with HIV live in developing countries and cannot afford life-saving HIV treatment. Starting in 2000, initiatives are launched to provide these countries and their communities with antiretroviral drugs at a reduced price.
 

Seeing as HIV is a virus, it should be possible to instruct the body to produce antibodies that detect and eliminate HIV when it infects someone. This is how the flu jab, the polio jab and other vaccinations work. Hopes were high for this first major HIV vaccination study.
 
5,100 gay men and 300 women from the United States, Canada and the Netherlands participated in this HIV vaccination study, which ended in 2003. The results were disappointing.
 

People had hoped it wasn't true, but this turned out to be the case: HIV can hide in dormant CD4 cells for decades. These dormant CD4 cells can be found in various places in the body. In your bone marrow, in your glands, in your intestines and in your liver. Dormant CD4 cells have also been found in the brain. 
 
These inactive, HIV-carrying CD4 cells are called HIV reservoirs. Antiretroviral drugs cannot reach them because they are only able to protect active CD4 cells. Scientists suspect that the longer you have had untreated HIV, the larger these HIV reservoirs become. 
 
To make it even more complicated, dormant CD4 cells can also wake up on their own, resulting in active HIV in your blood again. The only way to prevent HIV from spreading in your blood is to continue with HIV treatment.
 
To make a body completely HIV-free, all these dormant CD4 cells must be woken up and the HIV that is then released into your blood destroyed. But that is not easy.
 

A month of antiretroviral drugs immediately after you have been exposed to HIV appears to be very effective in preventing HIV infection. However, you must start the treatment within 72 hours. 
 
PEP (Post-Exposure Prophylaxis) is a great solution, given initially to healthcare workers who may have been exposed to HIV through a needlestick injury, for example. But soon after, it is made available to people who are worried because their condom has torn.
 

As life-saving combinations of antiretroviral drugs become the new normal, pill manufacturers are seizing on these developments to combine multiple antiretrovirals in a single pill. This makes it easier for people living with HIV to take their daily dose of anti-HIV medication.
 
People living with HIV usually have to take multiple types of anti-HIV drugs, with varying requirements and side effects, so a lot of attention is paid to taking the right pill on time. Some pills must be taken three times a day with high-fat food, others twice a day – in large amounts – on an empty stomach. The nasty tasting chewable DDI tablet, is sometimes prescribed once a day as well. 
 

It is now possible to determine the number of virus copies per millilitre of blood. This is a useful tool for doctors and researchers, as it allows them to see how the anti-HIV drugs are working. Previously, only the CD4 count was measured but this gave an incomplete picture. 
 
The first viral load tests are not yet very accurate, but they are improving every year. Now (2025), the best viral load tests can even detect a single virus copy. We know now that if you have fewer than 1000 virus copies per millilitre of blood, you can no longer transmit the virus.
 

Giving people with HIV at least three different types of antiretroviral drugs seems to slow down the damage HIV causes in your body. The combination proves so effective, the Minister of Health in the Netherlands makes it their mission to ensure that ‘combination therapy’ will be reimbursed by health insurance, to take effect immediately. 
 
This saves many lives. People with advanced HIV infection (AIDS) who are on the brink of death come back to life. This is called ‘the Lazarus effect’. This first version of combination therapy is not for everyone. For some people, the drugs are simply not effective enough and they die anyway. Others experience terrible side effects that cause them serious health problems, such as a total loss of fat cells throughout the body, or very severe forms of nerve pain.
 

More and more antiretroviral drugs are coming onto the market. Most of these drugs were developed in the 1960s but other, newly developed drugs are now also becoming available. 
 
What they all have in common is that they protect CD4 cells from HIV. One drug prevents HIV from multiplying in a CD4 cell, while another drug prevents the virus from entering a CD4 cell.
 
Efforts are already underway to combine anti-HIV medication and the results are encouraging, but HIV only appears to be truly inhibited when three different anti-HIV drugs are administered.
 

Doctors and researchers have noticed that while some people living with HIV develop AIDS very quickly, for others it is a slower process. They want to know why this is, and they set up an investigation.
 
In doing so, they come across some remarkable facts. For example, some people have HIV but naturally suppress the virus, and some people cannot contract HIV. It later turns out that these people have useful abnormalities in their DNA that allow their bodies to naturally control or even reject HIV.
 
In the case of people who cannot contract HIV, a gene mutation prevents HIV from attaching itself to the CD4 cell. This mutation is called CCR5-delta-32. If someone has inherited this mutation from both parents (and therefore has a double CCR5-delta-32 gene), HIV cannot attach itself to the CD4 cell. 
 
People with a single CCR5 delta-32 gene can still contract HIV but not easily, and it takes much longer for them to develop advanced HIV (or AIDS).
 
People who suppress HIV naturally (and therefore have a very low viral load) are called ‘elite controllers’. HIV copies itself in your DNA, but to work properly it must be copied in an active piece of DNA. There are also parts of your DNA that do not actually do anything. If HIV copies itself there, your body is less affected by the virus and may be able to clear away active virus copies itself.
 

Drug research often takes a very long time. Scientists and doctors must be very careful to ensure that the drugs really do what they say they do. Under pressure from AIDS activists, researchers are experimenting with a shorter timeline. 
 
Many people with AIDS participate in these experiments: for themselves, but also for those who come after them. In the words of prominent AIDS activist Vito Russo, “The side effect of AIDS is death”.
 

AZT was originally developed in 1964 to treat cancer, but it did not work. The current HIV epidemic means everything is being tried. So AZT is resurrected. Despite the fact that patients experience severe side effects, AZT does inhibit the virus. This gives researchers hope that it is possible to stop HIV.
 
Controversy arises because the pill manufacturer, Burroughs Wellcome, charges exorbitantly high prices for this old drug that has minimal effect. AIDS activists rise up against these profiteers.
 

Because it is now indisputably clear that HIV can be transmitted during sex, the Dutch government organises a national campaign to encourage people in the Netherlands to use condoms during sex.
 
Whereas other countries use shocking images of gravestones to warn about the consequences of AIDS, the Dutch are shown bees flitting from one flower to another. The message is: ‘If you have multiple sex partners you need to have safer sex, stop AIDS.’
 
The Netherlands embraces condom use en masse.
 

From the moment HIV was discovered, doctors knew they needed to monitor a person’s CD4 cells. The number of CD4 cells says a lot about the stage of the HIV infection.

At that time, there were no medicines yet to treat HIV. But by checking CD4 cells, doctors could act earlier to prevent or treat opportunistic infections.

To get a grip on the AIDS pandemic, the World Health Organisation collaborates with international health institutes to bring together scientists, doctors, researchers and policymakers. 
 
The international AIDS conference was held annually up to 1994 and then once every two years, each time in a different city. This AIDS conference was held in Amsterdam in 1991 and in 2018.
 
Since the conference in Montreal in 1989, there has also been scope for people with HIV themselves to be at a conference. AIDS activists held protests, demanding the right to participate in discussions about research, policy and treatment.
 

A group of people with AIDS gather in Denver in the United States and present what is now known as ‘The Denver Principles’. They demand that no decisions be made about them without involving them in the process. This also applies to HIV research. 
 
The Denver Principles mark the first time in history that patients have explicitly stood up for their rights. The declaration states, among other things, "We condemn attempts to label us as ‘victims’, a term that implies defeat. Nor are we merely ‘patients’, a term that implies passivity, helplessness and dependence on care by others. We are ‘people with AIDS’."
 

In May, a research team from the United States, and one from France, publish in the same scientific journal that they have discovered the virus that causes AIDS.
 
The American team calls the virus HTLV-III, and the French team calls it LAV. For a while, it remains unclear whether both teams have discovered the same virus. This turns out to be the case, and in 1986 the virus is given the name HIV: ‘Human Immunodeficiency Virus’.
 
HIV turns out to be a retrovirus. A retrovirus can copy its own genetic code (RNA) into the DNA of the host. This means that the host has no idea it is infected. HIV is therefore able to pretend that it is part of your body. This means it stays well hidden.
 

Although it is known that AIDS has now arrived in the Netherlands, there are still no ways to test blood for AIDS. People with the blood disorder haemophilia depend on blood donated by volunteers at the blood bank. 
 
During a consensus-based decision-making process with the blood bank, it is decided that gay men will be asked to stop donating blood. In 1988, it becomes the official policy of the blood bank to no longer accept blood from men who have sex with men. 
 
Since 2021, gay and bisexual men in monogamous relationships have been allowed to donate blood again.
 

During a July meeting of the American Institute of Public Health (CDC), a new name for the new disease is introduced: AIDS. AIDS stands for ‘Acquired Immunodeficiency Syndrome’. 
 
It has since been discovered that it is not only American gay men who show the symptoms of this new disease. People with the hereditary blood disorder haemophilia, intravenous drug users and (in America) immigrants from Haiti also show the symptoms.
 
The first Dutch man dies of AIDS at the AMC (Academic Medical Centre) hospital in Amsterdam. Doctors are at their wit’s end. They have never seen anything like this before.

In the summer, American media report on a rare cancer in relatively young gay men in New York and San Francisco.
 
The rare cancer turns out to be Kaposi's sarcoma, a skin cancer caused by a herpes virus. Normally, your immune system suppresses this virus, but when HIV has destroyed all your CD4 cells, the virus has a chance to take hold. It also turns out that a number of these men have a rare type of pneumonia caused by a fungus.
 
The American media's reporting on the rare cancer among gay men is seen as the starting point for AIDS research. This also marks the beginning of public awareness of the AIDS epidemic.

CD4 cells are immune cells that ensure that pathogens such as viruses, bacteria and fungi are detected in your body so that they can activate other immune cells to kill these pathogens. 
 
Shortly after the discovery of HIV, it was found out that HIV uses a CD4 cell to multiply. After being used, the CD4 cell dies. If you no longer have any CD4 cells, other viruses and germs can get out of control.

By testing old blood samples, researchers find HIV in the blood of a man who lived in Leopoldville, Belgian Congo, in 1959. (Now: Kinshasa, Democratic Republic of Congo). 
 
In the years before 1981, there were numerous mysterious deaths that puzzled doctors. Blood from these people that had been preserved would later be tested for HIV. It turns out that a number of people in the West also died from the effects of AIDS. For example, an American teenager in 1969, a Norwegian truck driver in 1976 and a Danish doctor in 1977. 
 
The situation in Africa was much more serious. 75 children participated in a medical trial in 1973. Some 50 of them were found to have HIV when their blood was tested for it in 1985.