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Yes it really a "wake and kill" approach. The virus is...

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    Yes it really a "wake and kill" approach. The virus is effectively sleeping when it is integrated into the DNA of the cell and none of the viral proteins that the antiretroviral drugs act on are expressed (the only viral protein expressed is TAT which keep the virus sleeping). When you activate the immune cells the virus starts replicating and then the drugs can work.

    The problem has always been that the virus can stay in the sleeping state for decades meaning no matter how long you take cART for the virus persists. If you stop taking cART then the small number of virus particles produced by newly activated cells can then start the normal HIV replication process again. For such a simple thing, HIV is a diabolic foe.

    The difficulty is finding a way to activate all the immune cells and not kill the patient. If you activate all the immune cells at once you create what is called a cytokine storm and the patient dies of multiple organ failure. The solution is probably going to be along the lines of using a series of a different activators in a cycle - a bit like trying to silence a piano by playing one note at a time and then cutting the wire that vibrates, rather than bashing down on all 88 keys at once and attacking the wires with an axe.
 
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