Globally, approximately 40 million people live with HIV. Advances in treatment have transformed the infection from a fatal diagnosis into a manageable condition, yet researchers have long sought a cure. Traditionally, individuals with HIV have needed to adhere to lifelong antiretroviral drug regimens.
However, a significant breakthrough reported in 2025 suggests the possibility of a 'functional' cure—a mechanism allowing HIV to be controlled long-term without constant treatment. In two separate trials utilizing infusions of engineered antibodies, some participants maintained their health without the need for ongoing antiretrovirals well after the studies concluded.
One of these trials, the FRESH trial led by virologist Thumbi Ndung’u at the University of KwaZulu-Natal and the Africa Health Research Institute in South Africa, saw four out of twenty participants maintain undetectable HIV levels for an average of 1.5 years without antiretrovirals. In the other study, the RIO trial based in the United Kingdom and Denmark and headed by Sarah Fidler, a clinical doctor and HIV research expert at Imperial College London, six of thirty-four participants have controlled the virus for at least two years.
These pivotal proof-of-concept trials indicate that the immune system can be effectively harnessed to combat HIV. The research community is now focused on conducting larger, more representative trials to determine whether antibody treatments can be optimized for broader efficacy.
Sarah Fidler commented, “I do think that this kind of treatment has the opportunity to really shift the dial, because they are long-acting drugs”—noting that their effects can persist even after the drugs are no longer present in the body. “So far, we haven’t seen anything that works like that.”
While people with HIV can have long and healthy lives if they adhere to antiretrovirals, their lifespans are generally shorter compared to those without the virus. Daily pills or new bimonthly injections can pose financial, practical, and social challenges, including stigma. “Probably for the last about 15 or 20 years, there’s been this real push to go, ‘How can we do better?’” says Fidler.