I receive a lot of angry e-mails asking me why doctors haven't made a cure for herpes or why there isn't an HIV vaccine when there is a vaccine for HPV. These e-mails often accuse me and other scientists of not trying or not caring, but the truth is that science just doesn't work that way. Many scientists have spent years working on herpes cures and HIV vaccines; they just haven't yet been successful in developing them.
The Difference Between Developing an HPV Vaccine and an HIV Vaccine
The HIV virus that causes AIDS and the HPV virus that causes genital warts, cervical cancer, throat cancer, and other genital cancers in men are both STDs, which makes many people wonder why we have a vaccine for one of them but not the other. However, developing an effective vaccine is far more difficult than just identifying the pathogen that causes a disease and knowing how it spreads. It requires figuring out a way to get the immune system to react strongly enough against that pathogen at the moment of exposure to fight off an infection.
HPV was a good target for vaccination since it had already been shown that many people's immune systems are capable of fighting off HPV infections on their own -- most people who become infected with HPV will clear the infection within a few years, with no help from a doctor or drugs. This gave strong evidence that, in theory, a vaccine against HPV could be made to work. It did. After several years of research, doctors figured out which HPV proteins were effective at stimulating the immune system and have used that knowledge to develop not one but two vaccines.
In contrast, the search for an HIV vaccine has been far longer and far less successful. Although scientists have spent many years, and many millions of dollars, trying to find a vaccine that will effectively prevent HIV, there is no guarantee that they will ever be able to do so. Unlike people with HPV, people with HIV do not generally fight off an infection on their own. This means that there's no proof that the body would be capable of getting rid of an HIV infection, even if you could successfully stimulate the immune system to react against the virus with a vaccine.
It is extremely difficult to develop an effective vaccine. Although the stories people read in school about the development of the smallpox vaccine make it seem easy, science is rarely that straightforward. Scientists have been working towards developing a chlamydia vaccine for more than 50 years, and we still don't have one. People didn't even know that HIV existed for most of that time. HIV-1 wasn't discovered until 1984.
Why Isn't There a Cure for Herpes?
The people who write me angry letters about the lack of a cure for herpes often seem to believe that a cure exists but their doctors don't know about it or are hiding the cure from them. In part, this is likely due to the large number of fraudulent STD treatments, in particular fake herpes cures, that are advertised on the internet. However, it also may be partially due to the fact that we live in a society where herpes is so stigmatized that not even doctors want to talk about it.
However, the fear that there is a cure for herpes out there and people don't know about it is completely unfounded. Herpes is a huge problem, and if someone developed a herpes cure they would probably win a Nobel prize. The real issue is that herpes behaves in a way that makes it very difficult to attempt a cure. Although it is possible to prevent outbreaks with suppressive therapy or reduce the pain of an outbreak with conventional or alternative treatments, developing treatments is very different than knocking the virus entirely out of a person's body.
When herpes infections aren't active, the virus hides out in the cells of the nervous system -- where drugs cannot find it to get rid of it. In order to cure herpes, as opposed to simply treat it, scientists need to find a way to get all of the hidden virus out into the open where it can be removed. There has been some progress on this front in recent years, but the research is still in its early days. That's not to say that people shouldn't have hope, but even in the very best of circumstances, it takes years to go from an in vitro solution that works in the lab to a safe and effective drug that works in the human body. Furthermore, not all treatments that work in the lab work equally well, or at all, in people, so even an extremely promising early article is not a guarantee of a future cure.
Science is a Process
Drug and vaccine development are long, difficult processes that involve many years of work, and many wrong turns, with no guarantee of success. In no way does the lack of a herpes cure or an HIV vaccine mean that doctors and scientists don't want to find them. Many scientists are working incredibly hard trying to do just that.
Although if you have HIV or herpes it may sometimes seem like researchers don't understand or care about what you're going through, it's not true. Everyone working in the field recognizes that these and other sexually transmitted diseases are a major source of physical and emotional distress around the world, and people are constantly looking for new ways to treat these diseases and also stop their spread.
It may seem difficult to believe when you don't understand why there isn't a cure for your infection right now, but there are doctors and scientists who are dedicating their lives to looking for one. We just need to keep funding their research and hope that one day that they succeed.
Bell, SD Jr; Nichols, RL; Haddad, NA. "The Immunology of the Trachoma Agent With a Preliminary Report on Field Trials on Vaccine." Invest Ophthalmol. 1963 Oct;2:471-81