By Christine Goffinet

Chair in Virology

Liverpool School of Tropical Medicine

For over 125 years, Liverpool School of Tropical Medicine (LSTM) has been a world leader in global health research, helping to identify, treat and eliminate some of the world’s deadliest diseases. Today, my research team is focused on finding a cure for HIV, a life changing disease that affects over 112,000 people in the UK, and millions worldwide.

Antiretroviral therapy (ART) is one of the greatest achievements in global health research. It can keep the virus suppressed and can allow people to live long, healthy lives. But it isn’t a cure and was never designed to be a permanent solution. Many suffer side-effects, serving a daily reminder of their HIV status.

Worldwide, 39 million people live with HIV, and 1.3 million acquired the infection last year. Keeping them on ART for life costs over $21.9 billion annually and access to these drugs depends on political will, continued funding, and complex supply chains. The fragility of this system was recently brought into stark relief by significant funding cuts to global HIV programmes. These cuts are projected to drive up new infections and deaths in the coming decades. A cure wouldn’t remove the need for HIV investment overnight, but it would create a far more robust and reliable system.

But, if the need is so great, why hasn’t a cure been found? HIV is a very sophisticated virus. It hides, dormant, inside immune cells, invisible to treatments and the immune system. My team is seeking to outsmart the virus with “shock and kill” treatments; waking the sleeping virus up, and then using natural immune signals to help the body’s own immune cells to recognise and destroy it. This is cutting edge science being worked on right here in Liverpool.

LSTM’s research also focuses on HIV as a global disease. Most HIV cure research focuses on the viral subtype most common in the US and Europe, but a different subtype found in Southern African and Southeast Asia accounts for nearly half of infections worldwide. A cure for only on subtype will never be effective, so I’m reaching out beyond Liverpool, working with researchers in South Africa, Malawi and beyond to develop a truly global and lasting cure.

An HIV cure can’t be designed solely in a lab. Recently, Sahir House and George House Trust invited us to learn from people living with HIV at an event titled “Have Your Say on HIV Cure Research”. We had fascinating discussions, learning that some were happy to continue ART indefinitely, but that many were desperate for a cure. It was also clear that proving people’s cured status was essential, although this would require finding an alternative to a standard antibody test because HIV antibodies would always be present even if cured. We’re now working with both organisations to expand this work with an ongoing Patient Advisory Group, so community voices can continue to shape our research.

There is a famous, anonymous quote that I often think about, “One day, I’d love to say, ‘I used to have HIV'”. These words inspire me, finding a cure and helping to realise this person’s dream keeps me going. The power of these words also shows that the voices of people with HIV are essential in shaping LSTM’s work and convincing funders and governments to continue supporting research efforts.

I’m grateful to Sahir House and George House Trust for their partnership, and to everyone who has shared their experience with us. If you’re living with HIV and want your voice heard, we’d love to hear from you.