22.1  The difference between treatment and cure in HIV/AIDS

Knowing the difference between treatment and cure is quite important in providing care to patients with chronic illnesses like HIV/AIDS. Treatment is the application of a medicine or a remedy to relieve symptoms and/or signs of an illness; in the context of a communicable disease like HIV/AIDS, it doesn’t necessarily mean getting rid of the infectious agent from the patient’s body.

On the other hand, cure means eradication of the cause of the illness — the complete removal of the pathogen from the body; for example, there is a cure for malaria or tuberculosis, but not yet for HIV.

You need to understand that antiretroviral therapy for HIV does not cure HIV, because it cannot eradicate the virus from the body. Even though effective treatments to control HIV exist now, there is still no cure. It is important that you make sure all the PLHIV in your care also understand this, for the following reasons:

• HIV treatment is for life: It will be easier for PLHIV to understand that, because it is not curative, HIV treatment will be for the rest of their lives, and they must continue taking the drugs even though they may have adverse side-effects (which will be covered later in this study session).
• Drug resistance: You will be better placed to explain to PLHIV that if treatment is interrupted, HIV may become drug resistant, that is, the virus in their bodies will not respond to treatment in future because the virus is no longer susceptible to the drugs. If this happens, it will be necessary to use other drugs that may not be as effective in keeping the virus levels in the blood down, or that may have more side-effects (drug resistance will be referred to again later in this study session).
• Minimising risk of transmission: Since there is still no vaccine to prevent HIV, you will need to educate and discuss prevention strategies with PLHIV consistently. They must understand that they are still able to transmit HIV to a healthy uninfected person, even if they feel healthier because they are on ART.