Researchers at Case Western Reserve University uncover HIV mystery that could unlock the path to a cure
CLEVELAND—For over three decades, HIV has played an elaborate game of hide-and-seek with researchers, making treating—and possibly even curing—the disease a seemingly insurmountable obstacle to achieve.
But scientists at Case Western Reserve University have made a breakthrough discovery that could fundamentally change strategies for treating HIV.
The team identified for the first time how HIV enters a dormant state in infected cells that allows the virus to “hide” from the immune system and current treatments.
The researchers believe the finding, just published in Nature Microbiology, challenges decades of scientific assumptions and opens a new approach to possibly eliminating the deadly virus.
“This discovery rewrites what we thought we knew about how HIV goes into this stealth mode in the human body,” said study lead Saba Valadkhan, an associate professor in the Department of Molecular Biology and Microbiology at the Case Western Reserve School of Medicine. “We’ve shown that HIV actually orchestrates its own survival by reprogramming host cells to create the perfect hiding place.”
The team discovered that HIV uses a clever survival trick that explains why it’s been impossible to cure. After HIV invades a cell, it sneaks its genetic code into the cell’s DNA, then tricks the cell into going to sleep, which also puts the virus to sleep, making both completely invisible. This tactic makes the infected cell invisible to the immune system and unreachable by even today’s most advanced HIV drugs. The virus stays hidden in these dormant cells until the right moment to “wake up” and spread again, creating an undetectable reservoir that ensures HIV never goes away completely.
“What we’ve uncovered is that HIV doesn’t just randomly go dormant—it actively manipulates the host cell to create conditions for its own survival,” said study collaborator Jonathan Karn, Distinguished University Professor and chair of the Department of Molecular Biology and Microbiology. “This gives us specific targets to attack.”
The findings may extend far beyond HIV treatment. The researchers believe similar dormancy actions could be triggered by other viruses—including herpes, hepatitis and other retroviruses—potentially leading to new therapies for many viral diseases.
“We may have uncovered new tactic viruses use to trick the host cells to do their bidding,” Valadkhan said.
This discovery is also important for protecting public health worldwide because viruses like HIV—which can permanently insert themselves into a person’s DNA—could potentially be used as future viral threats and pandemic preparedness.
Established HIV research environment
The groundwork for such a discovery was supported by Case Western Reserve’s long-standing interdisciplinary collaboration and robust HIV research infrastructure. The School of Medicine houses a National Institutes of Health-designated Center for AIDS Research founded more than 30 years ago, and the Center for Excellence on the Impact of Substance Use on HIV, providing access to cutting-edge technologies essential for high-impact HIV research.
The research team is now confirming their findings and developing new treatments based on this discovery.
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About Case Western Reserve University
As one of the fastest-growing research universities in the United States, Case Western Reserve University is a force in career-defining education and life-changing research. Across our campus, more than 12,000 students from around the world converge to seek knowledge, find solutions and accelerate their impact. They learn from and collaborate with faculty members renowned for expertise in medicine, engineering, science, law, management, dental medicine, nursing, social work, and the arts. And with our location in Cleveland, Ohio—a hub of cultural, business and healthcare activity—our students gain unparalleled access to academic, research, clinical and entrepreneurial opportunities that prepare them to join our network of more than 125,000 alumni worldwide. Visit case.edu to see why Case Western Reserve University is built for those driven to be a force in the world.
Journal
Nature Microbiology
Method of Research
Experimental study
Subject of Research
Cells
Article Title
HIV infection reprogrammes CD4+ T cells for quiescence and entry into proviral latency
Article Publication Date
26-Sep-2025
CUNY SPH Assistant Professor Phil Kreniske awarded $5 million to improve mental health and HIV care for adolescents in Uganda
CUNY Graduate School of Public Health and Health Policy
image:
Young people travel along a rural road in Uganda
view moreCredit: Courtesy of Assistant Professor Philip Kreniske
New York, NY | September 30, 2025: The National Institutes of Health (NIH) has awarded Dr. Philip Kreniske, Assistant Professor at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), $5,115,391 for a groundbreaking research project to improve mental health and antiretroviral treatment adherence among adolescents living with HIV in rural Uganda.
The study, Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS), addresses critical gaps in care for young people living with both HIV and depression.
Adolescents living with HIV face unique challenges that can affect both their mental health and their ability to maintain treatment. In low- and middle-income countries, one in four adolescents with HIV experiences poor mental health, a major factor that contributes to missed medications and lack of viral suppression. However, this creates a major gap between the need for mental health services and the availability of evidence-based care. This gap is especially critical in sub-Saharan Africa, home to the majority of the world’s 1.7 million adolescents living with HIV, where few evidence-based mental health interventions have been proven effective for young people.
The STREAMS study will be implemented across 24 HIV clinics affiliated with the International Center for Child Health and Development (ICHAD) in Uganda's Masaka region, using a cluster-randomized trial to evaluate the effectiveness of the intervention in reducing depressive symptoms and improving medication adherence. The researchers will also explore barriers and facilitators to care.
"STREAMS stands on the shoulders of giants—decades of work, from the biomedical breakthroughs in HIV treatment and the historic distribution through PEPFAR, to the careful adaptation of mental health programs in Uganda,” says Kreniske, an investigator at the CUNY Institute for Implementation Science in Population Health (ISPH). “Our innovation is to take these proven, life-saving tools and combine them. By leveraging simple mobile technology for mental health screening, we can integrate mental health, economic empowerment, and medication support into a single, powerful system for youth. This approach can transform young lives and offer insights for improving community mental health care worldwide."
The study is expected to provide critical evidence to guide scalable mental health and HIV treatment services for adolescents in sub-Saharan Africa.
“What makes STREAMS so important is its focus on testing evidence-based interventions in real-world service delivery settings, with attention to feasibility and scalability should it be found to be impactful,” says CUNY SPH Distinguished Professor Denis Nash, executive director of CUNY ISPH.
Dr. Kreniske will work in collaboration with Dr. Proscovia Nabunya from Washington University, CUNY SPH faculty Drs. Chloe Teasdale and Sasha Fleary, and investigators from the New York University Silver School of Social Work and StrongMinds, which provides free, evidence-based, culturally relevant mental health care to the world’s most under-resourced populations.
Research reported in this press release was supported by the National Institute of Mental Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award numbers K01MH122319 and R01HD074949.
Media contact:
Ariana Costakes
Communications Editorial Manager
About CUNY SPH
The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to promoting and sustaining healthier populations in New York City and around the world through excellence in education, research, and service in public health and by advocating for sound policy and practice to advance social justice and improve health outcomes for all.
About CUNY ISPH
The CUNY Institute for Implementation Science in Population Health (ISPH) was founded on the notion that substantial improvements in population health can be efficiently achieved through better implementation of existing strategies, policies, and interventions across multiple sectors. With that in mind, we study how to translate and scale up evidence-based interventions and policies within clinical and community settings in order to improve population health and reduce health disparities. cunyisph.org
