Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

Karine Dubé; Loreen Willenberg; Lynda Dee; Laurie Sylla; Jeff Taylor; Christopher Roebuck; David Palm; Danielle Campbell; Luke Newton; Hursch Patel; Kelly E Perry; John Kanazawa; Jo Gerrard; Brandon Brown; Parya Saberi; John A Sauceda; Michael J Peluso

doi:10.1016/j.jve.2020.100017

Re-examining the HIV 'functional cure' oxymoron: Time for precise terminology?

J Virus Erad. 2020 Oct 14;6(4):100017. doi: 10.1016/j.jve.2020.100017. eCollection 2020 Nov.

Authors

Karine Dubé¹, Loreen Willenberg², Lynda Dee^{3

4

5

6}, Laurie Sylla^{6

7}, Jeff Taylor^{4

6

8

9

10}, Christopher Roebuck^{6

11

12}, David Palm^{6

10

13}, Danielle Campbell^{5

6

14}, Luke Newton¹, Hursch Patel¹, Kelly E Perry¹, John Kanazawa¹, Jo Gerrard¹⁵, Brandon Brown¹⁶, Parya Saberi¹⁷, John A Sauceda¹⁷, Michael J Peluso¹⁸

Affiliations

¹ UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
² Zephyr LTNP Foundation, Inc., Sacramento, CA, USA.
³ AIDS Action Baltimore, Baltimore, MD, USA.
⁴ amfAR Institute for HIV Cure Research Community Advisory Board (CAB), Palm Springs, CA, USA.
⁵ Delaney AIDS Research Enterprise (DARE) CAB, Baltimore,MD and Los, Angeles, CA, USA.
⁶ Martin Delaney Collaboratory CAB, Baltimore, MD; Seattle, WA; Palm Springs, CA; Ithaca, NY, Los Angeles, CA, USA.
⁷ DefeatHIV CAB, Seattle, WA, USA.
⁸ HIV + Aging Research Project - Palm Springs (HARP-PS), Palm Springs, CA, USA.
⁹ University of California AntiViral Research Center CAB, San Diego, CA, USA.
¹⁰ Collaboratory of AIDS Researchers for Eradication (CARE) CAB, Chapel Hill, USA.
¹¹ BEAT-HIV CAB, Philadelphia, PA, USA.
¹² Department of Science and Technology Studies, Cornell University, Ithaca, NY, USA.
¹³ Institute of Global Health and Infectious Diseases (IGHID), University of North Carolina at Chapel Hill, NC, USA.
¹⁴ Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA, UCLA, Los Angeles, CA, USA.
¹⁵ University of California Riverside School of Medicine, Riverside, CA, USA.
¹⁶ Center for Healthy Communities, Department of Social Medicine and Population Health, University of California Riverside School of Medicine, Riverside, CA, USA.
¹⁷ Division of Prevention Science, Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA.
¹⁸ Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA, USA.

Abstract

For over a decade, the binary concepts of 'sterilizing' versus 'functional' cure have provided an organizing framework for the field of HIV cure-related research. In this article, we examine how the expression 'functional cure' is employed within the field, published literature, and community understanding of HIV cure research. In our synthesis of the different meanings attributed to 'functional cure' within contemporary biomedical discourse, we argue that employing the 'functional cure' terminology poses a series of problems. The expression itself is contradictory and inconsistently used across a wide array of HIV cure research initiatives. Further, the meaning and acceptability of 'functional cure' within communities of people living with and affected by HIV is highly variable. After drawing lessons from other fields, such as cancer and infectious hepatitis cure research, we summarize our considerations and propose alternative language that may more aptly describe the scientific objectives in question. We call for closer attention to language used to describe HIV cure-related research, and for continued, significant, and strategic engagement to ensure acceptable and more precise terminology.

Keywords: Community engagement; Control; Functional cure; HIV; HIV cure research; Immunity; Journal of virus eradication; Language; Suppression; Terminology.

Abstract

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