I think it needs to kill more than 6-9's before it has a good chance at being a cure.
A given strain can have some variability but will share general traits.
HIV strains are named and numbered: https://en.wikipedia.org/wiki/Subtypes_of_HIV
An efficient treatment against a specific strain would save millions of lives. An efficient treatment against the 99% of them that are the most prevalent would basically solve the epidemics.
The problem is that people often end up with more than one strain. This is why doctors tell HIV+ people to continue protect themselves and were worried about the appearance of "free-sex parties" for HIV+ individuals. Most people do not differentiate between strains but if you got HIV from a partner, you may have had only a part of their strains, you should not have unprotected sex if you want to maximize your chances.
Given this drug kills 99/100 HIV virus units, then this really only helps you for log2(100) or ~7 generations
The math is pretty easy, but the results are something that always surprise me: it turns out humans are pretty bad at estimating exponential growth.
0: real life conditions are probably slower than this, I concede.
Which is long enough for you to complete your lunch! :-)
That most virulent 1% then multiplies and infects systemwide... and adds new mutations all the time.
This is true not just for bacteria but also for other living creatures; for example animals that have lots of children have very short average lifespans.
It makes me think that every living species must be at the absolute cutting edge of its capabilities genetically-speaking.
Another illustration of that is, if 99.99% equates to 1/10000 survivors, the meaning of it depends on how many bacteria exist on the area in the first place. It has quite a different meaning if the typical number is 10000 vs if it's 100000000
Then avoid dipping your hand into beef stew for too long. Most of time, germs grow like sigmoid function.
Not that we should consider in insurmountable nor ungrasp-able. But that we -- or parts of our society and professional institutions -- should lose some of our arrogance.
On the upside, that complexity also harbors enormous opportunity. Just, don't be simplistic about it an let your ignorance take you into disaster.
Granted, also, that there are lots of doctors who do follow research.
That's basically what HAART (the technique we've used to treat HIV successfully for the last 25 years) is. People take three antiretrovirals simultaneously. They're designed such that, for the virus to adapt to one, it has to make itself more susceptible to one of the other two.
That's not really accurate. HAART works because the 3 drugs are taken simultaneously, and it's extremely unlikely for a virus to get random mutations that confer resistance to all three in one generation.
That is literally exactly what I said. The drugs are taken simultaneously, and it is very difficult to develop resistance to all three simultaneously, because becoming more resistant to one means becoming more susceptible to another.
For example, suppose you take ATripla, which is a combination of efavirenz, emtricitabine, and tenofovir. If a viral particle has a random mutation that confers resistance to, say, efavirenz, that mutation does not make the virus more susceptible to emtricabine or tenofovir. The fact is the virus was already susceptible to those two drugs (that's why you take tests that specify your viral strain's pre-existing resistances to determine the best drugs for you before you start HAART), so it still is unable to replicate.
It's just a matter of statistics, not that resistance-granting mutations naturally make the virus more susceptible to other drugs.
I think the problem with a widespread, highly studied virus like HIV is that a "good enough" treatment isn't "good enough." Any treatment will be deployed in a limited manner to test the efficacy, which will in turn give it a chance to develop a resistance and spread.
That having been said, if the treatment CAN treat 99% of current infections, it will be a boon for at least a couple generations of gay and minority communities in the developed world.