Even though ART has improved the standard of care in HIV, a significant subset of PHLW are drug resistant due to suboptimal therapy prior to combination treatment and/or poor adherence. This subset is notably present in major cities in the United States in California, New York, Illinois, Florida and certain countries, such as Brazil and Thailand, where there was widespread use of mono- and duo-therapy in the 1980s and 1990s. Plus, substantial numbers of HIV patients fail to adhere to their ART regimen due to a variety of reasons, including adverse side effects, drug abuse, mental disorders, socioeconomic status, literacy, and social stigma. Such patients have ongoing viral replication, often with significant levels of plasma viremia, and, therefore, have severely compromised immune systems, with limited options and an inexorable pathway to significant morbidity and, ultimately, death.

Despite significant efforts, little progress has been made to ameliorate patients with unsuppressed plasma viremia. Indeed, the challenge is so significant that it has escaped solving by researchers for decades. The Seraph Research Institute team are investigating new approaches designed to treat people with uncontrolled HIV viremia.