It may be possible to trigger the expression of certain HIV proteins in infected cells, thereby making them recognisable to the immune system without causing the release of new virus particles. As part of this approach, IL-2 or a therapeutic vaccine might be used to enhance immune responses against these infected cells. Alternatively, immunotoxins might be employed to selectively kill latent infected cells.

Other strategies have been proposed for HIV eradication, including temporarily suppressing the immune system to kill off inactive infected cells, various forms of gene therapy and even surgical removal of lymph nodes with high levels of HIV activity.

Early in the epidemic, immune suppression followed by a bone marrow transplant from an HIV-negative donor was proposed as a possible way to get rid of HIV-infected CD4 cells; one American activist even tried a bone marrow transplant from a baboon. A few people with AIDS who received bone marrow transplants before the advent of HAART had undetectable HIV after the procedure, but eventually the virus came back.

More recently, French researchers reported on an HIV-positive man who was taking HAART and had an undetectable blood viral load before receiving a bone marrow transplant. After the transplant, ultrasensitive tests did not find any HIV genetic material in more than a million tested cells. But after the man had to stop taking antiretroviral therapy due to drug toxicity, both his blood viral load and HIV proviral DNA in cells again became detectable^[1].

Despite these setbacks, some experts remain optimistic about the prospects of permanently suppressing HIV. Whilst such approaches might not totally eliminate HIV from the body, they could potentially extend the amount of time that people can spend off treatment.