Around the globe, approximately 40 million individuals are living with HIV. While advancements in treatment have transformed the infection from a fatal diagnosis to a manageable condition, a cure has remained elusive. HIV-positive individuals must adhere to a lifelong regimen of antiretroviral medications.
However, in 2025, a major breakthrough was announced, suggesting that a 'functional' cureāwhere HIV is controlled long-term without continuous treatmentācould be within reach. In two separate trials involving engineered antibodies, some individuals maintained their health without antiretrovirals well after the interventions had concluded.
One of these trials, known as the FRESH trial, was led by virologist Thumbi Ndungāu from the University of KwaZulu-Natal and the Africa Health Research Institute in South Africa. Four out of twenty participants achieved undetectable HIV levels for a median of 1.5 years without antiretroviral drugs. The second trial, the RIO trial, was conducted in the United Kingdom and Denmark under the guidance of Sarah Fidler, an HIV research authority at Imperial College London. In this study, six of thirty-four participants managed to control the virus for at least two years.
These groundbreaking trials demonstrate the potential of harnessing the immune system to battle HIV. Researchers are now planning larger studies to determine if these antibodies can be optimized for broader application.
Fidler expressed optimism, stating, 'I believe this treatment has the potential to significantly change the landscape as these are long-acting drugs,' with effects continuing beyond their presence in the body. 'We haven't encountered anything like this so far.'
While antiretrovirals allow those with HIV to live healthy lives, their life expectancy often remains lower than those without the virus. Additionally, the need for daily medication or even newer, bimonthly injections poses financial, practical, and social challenges, including stigma. 'The question of how can we improve treatment has been a focus for the last 15 to 20 years,' Fidler notes.