You all know me.
There are two things I really love:
- Studying HIV
- Using viruses for gene therapy
One would think I would be over-the-moon about the FDA approving human trials for a gene therapy to stop HIV. HIV! Gene therapy! YAY!!
When this line of research initially emerged, I WAS super excited:
Go read that.
Now, just to be clear, that was in no way a 'functional cure'. No one in that small trial was 'functionally cured'. But I still thought it was a great, creative step in a positive direction:
4– No way this is a viable world-wide ‘cure for HIV/AIDS’. But it is more viable than bone marrow transplants, and optimizing this protocol could get it cheaper/faster/safer for the developing world, aka, the place we really need a cure for HIV/AIDS.
But this is really cool. Really cool step in a positive direction.
... But then this happened:
The road to Hell is paved with good intentions– HIV patient gets the one therapy that can cure HIV, dies
An attempt to replicate the results seen in the really functionally cured 'Berlin Patient' did not result in a second person cured of HIV.
It resulted in yet another HIV death.
How? If HIV needs CCR5, and they replaced this patients bone marrow with cells that could not make CCR5, how did he die from AIDS?
Because while HIV likes CCR5 as a co-receptor to infect cells... it doesnt need it. The natural diversity of a patients quasispecies will contain some variants of HIV that can use a different co-receptor, CXCR4.
Viruses that use CXCR4 are assholes.
In this second patient, the radiation/chemo did not kill all of the cells latently infected with CXCR4-tropic viruses. When those viruses 'woke up' in their new environment, and no CCR5-tropic viruses as competition, they went nuts. Oh, and they must have also been resistant to antiretrovirals. For more complications.
So, yeah, the attempt to generate another Berlin Patient, another person 'functionally cured of HIV!'... lead to a mans death.
"Oh my god, what are all those scientists going to do!" I thought. I knew there were a lot of people working on alternative ways of making people delta-CCR5, but if that can kill someone, there was no way they were going to be able to move forward with any clinical trials in people.
Best of luck to them. But we know what happens with patients treated with maraviroc (a protein that masks CCR5, doesnt delete it)-- The quasispecies figures out a way around it. We know what happens if there is a CXCR4-tropic virus hiding out somewhere when we give someone a delta-CCR5 bone marrow transplant.
Rather than attempting a 'functional cure', I think it would make a lot more sense to use gene-editing technologies as an 'HIV vaccine'-- CCR5 viruses are the ones who 'get through' to establish infection via heterosexual and homosexual contact. CXCR4 viruses dont like doing that. *shrug*
So while an at-risk person might not be born delta-CCR5, does making them kinda-delta-CCR5 (these gene therapy approaches are not perfect) during exposures help them keep from getting infected in the first place? That would be fantastic!
And since you are not fighting with active viral replication and an already-established quasispecies with already established reservoirs, like you would be in an already-infected individual, Id think the risk of ending up with another CXCR4-dead-patient would be virtually non-existant.
But I dont work for this company and no one is asking me. So again, I wish them the best of luck. And I hope no one gets hurt.
- Log in to post comments
Very interesting. This is the closest they have got.Although doesn't the HIV mutate its self ? Even if you find a cure for it won't there be another type that will be more resistant to the cure and antiratroviral?14047366
Wow amazing. people that are carriers of HIV have the virus in their body but it does not affect or damage the immune system. when a person have HIV and under go the functional cure of HIV does this make the individual a carrier? this also relate to cancer, are these the only sicknesses that can be maintained by the functional cure?
I agree. To develop a HIV-vaccination and decrease the number of HIV infected persons will have better long term results. Although patient that are already infected will not benefit from this, it will be a better solution for the future.
Nowadays people that suffers from HIV/AIDS lives up to 8 years while being infected with the virus. Antiretroviral strengthens their immune systems enough to fight more common illnesses like Tuberculosis and flu. Thus I think that the focus of scientists must rather be on developing a vaccination than a cure. It makes sense to me to rather decrease the future number of HIV infected patients by vaccination, than to try and develop a cure which only leads to more deaths.
But I think that first the number of HIV infected persons can be drastically reduced if we start to live with precautions. HIV can be prevented by individuals!
It's great that they are working on finding a cure, but a vaccination makes more sense to me. I understand that there are a lot of humans currently infected with the HIV virus and who has AIDS, and the idea that we can help them in the future pleases me, but wouldn't it be better to spend this time and energy and instead develop a vaccination that can stop the HIV virus altogether? For example, Rabies was stopped by vaccinations, not a cure. If you haven't been properly vaccinated and didn't treat your bite wound by the rabid animal correctly, Rabies will be fatal to you. You cannot cure it if it was in your bloodstream long enough. All of this considered, humans do not fear Rabies like they used to and this is all thanks to vaccinations. Thus wouldn't it just make more sense to stop these experiments that might, or might not kill the patients and just focus on a vaccine? The threat will decrease and then they can work on finding an actual cure to help the people that have been infected.
An old saying exists that says, “Prevention is better than cure.” While I believe in finding a cure for HIV, I personally think that scientists’ and researchers’ time would be better spent finding an effective method of prevention that does not deal with education, abstinence and using protection. While I do believe in these methods, I feel that because of how sexually orientated we, as humans, are, sex will always be a popular thing in society. Be it inside or out of wedlock, protected or unprotected, with someone whose sexual history you know or not. This is why I agree with finding a vaccine. A vaccine would be the perfect method of prevention, such that people would not need to change their lifestyle at all. Lifestyle changes are a very tall order, especially for developing countries, as people living in these countries only know their own lifestyle and will not easily change from it. HIV/AIDS is still the most prominent reason for death in Africa and it is not improving. Why not change the way we view solutions? Perhaps this change of thinking will be what saves us eventually. [#15013252]
(See https://cdn1.vox-cdn.com/uploads/chorus_asset/file/2928704/africa_death… and http://www.voxeu.org/article/aids-prevention-abstinence-vs-risk-reducti…)
I do not agree with the idea that scientists should rather be focusing on developing a vaccine than finding a cure because there is such a large population living with the virus. The care of these people should be the priority. Once a cure has been found, we can backtrack and develop a vaccine to prevent further infection. Research into finding a cure and developing a vaccine can take place simultaneously, as long as research into finding a cure is ongoing.
Have non of you ever wondered if there weren't already a cure for HIV but it is kept silent, because currently it is almost the only illness that decreases the human population? This may seem silly, but like in TV series there are people manipulating this world. We can cure almost anything except HIV. Its the same with energy sources. There could have been a green way of producing energy for use but maybe the companies who are currently supplying energy bought the "idea" and kept it silent to help themselves survive. Also this may seem negative but there are ways of preventing HIV not even needing to list them. But people still doesn't take it serious for me making it their own problem. If you play with fire you will get burned... Although it will be great if people who were infected due to other causes and those who played with fire and got burned can be helped.
It is better that they find the cure than the vaccination because many people are already infected with the virus. The cure will help people who are already infected and those who will get infected in the future while the vaccination will help people who are not yet infected with the virus.15147208
I am sure the one will lead to the other. It does not have to be either / or. They can research a vaccination as well as a cure. I would like to know how far the research is in finding a vaccination because a lot of material is found on the cure of HIV, but not as much on vaccinations for HIV?
It is so amazing how the Berlin patient was cure do for HIV but very unfortunate how the other patient did not survive the same treatment. I definitely agree that finding a cure is vital and a key tool for eradicating the virus completely in the future. However, prevention is better than cure and the best option currently, until a suitable cure is found. If a discovered vaccine is so effective in preventing HIV, it could give scientists certain clues they might need in developing a cure for the virus and ultimately put less pressure or urgency on them (which may be a reason why finding a cure is so challenging) as they have an effective vaccine to fall back on, which limits the future number of patients that will be infected.
I cant believe that up until today no one has found a cure for HIV. Since I was old enough to make sense of what was going on around me, I was hearing of HIV. I'm so tired, and to think that it is still defeating us! I don't agree with the idea of just finding a vaccine and not going on with the search for a cure, but what about those poor guinea-pigs that are dead? Let's just hope that there will still be people willing to sacrifice themselves to these experiments. But can someone just get it already!
I agree with the idea that "prevention is better than cure" in comment #6 but how are we supposed to rely on preventative methods when it does not seem to be effective currently and also taking into consideration the fact that HIV positive people are not consistent in taking ARV's already?
I do not agree, however, that it may be possible that a cure for HIV may be "kept silent" as mentioned in comment #8 given that HIV is a prominent health concern and considered a epidemic in South Africa. Therefore, with countless deaths already recorded, I doubt that a cure will be "kept silent" at the expense of so many lives.
With regards to the comments made about prevention being better than the cure; I find that to be a bias and unethical view. This is because it suggests that one should save the heathy from getting sick and let the infected die out. Finding a cure is very relevant as this virus can stay in one's body for many years and should be retarded before it can cause further damage in one's body. I find it very exciting that gene therapy is being looked at to put this virus to a halt and that scientists are finally getting closer to creating a 'functional cure'(as the writer would put it).
There is a case I also heard of called "Patent #5676977" which is a so-called cure for AIDS. Many people are unfamiliar with cases such as these and are not familiarized with it. As mentioned in comment #13, possible cures might have been "kept silent" over the past few decades. It is our responsibility to engage in research and "killing the silence" which keeps these cases a secret. And then furthermore, perhaps rather than creating a "vaccine" , they could find a legitimate cure for HIV/AIDS.
I don't necessarily agree that "prevention is better than cure" especially in the context of AIDS today. I do however believe with regards to this article, gene editing technologies would be better used as a "vaccine" as apposed to a cure. If blocking the CCR5 receptor reduces the likeliness of infection then why not?... However the only thing that did come to mind is looking at where HIV takes the biggest toll ...it isn't the areas in which gene therapy and the facilities for it are readily available.. if most of the problem is based in third world countries... i have my doubts as to whether this would be a viable solution
Although the functional cure proved to be fatal for the second patient, it is still an amazing breakthrough in science. if the use of it as a vaccine, rather than a cure, could lead to better results then it should be done. (15038697)
This is very interesting. With regards to comment #8, the thought crossed my mind as well. I then came across the 5676977 Patent, which is a "potential cure". Why has it not been published?
I feel that a vaccine and a cure is needed. A vaccine would only be beneficial to individuals that are HIV negative. But what about the millions of people that are HIV positive? It was a goal in South Africa to produce a HIV-free generation. This could be achieved by scientists working together to developing a cure and a vaccine simultaneously, or making "existing ones" known to the public.
I support th view of #6 S Fobian. Research should continue to focus on a vaccination however prevention should be high on priority list. Prevention should not include abstinence and education but a compulsory vaccination from an early age to assist the human body with arming its immune system against HIV AIDS. Furthr to this comment I believe that the government should do more with regards to getting antiretrovirals easily available to the affected people and to have a more controlled approach.
HIV/AIDS is the largest killer in Africa. It is the disease that takes the most lives yearly and weather we develop a cure or a vaccine first does not matter. In both circumstances we are solving the problem.
A vaccine, however, will probably turn out to be the more economic option but a cure will do mounds of good as well. I also feel that HIV/AIDS can be prevented by interventions such as contraception, education and free clinics initiated by governments all around the world.
Considering the comment made by #6 S Fobian, I completely agree. Humans are sexually inclined creatures, the spread of this disease is inevitable without a vaccine.
After reading the blog. I support the view of #6 S Fobian. Research should continue to focus on a vaccination however prevention should be high on priority list. it should be emphasized how important it is. Prevention should not include abstinence and education but a compulsory vaccination from an early age to assist the human body with arming its immune system against HIV AIDS. Further to this comment I believe that the government should do more with regards to getting antivirals easily available to the affected people and to have a more controlled approach.
Even though I am in favour of research about illnesses, would it really be possible to find a cure for HIV? And is it really worth it to use resources on research for it when it can be used elsewhere where a difference can be made immediately? For instance more than a million people die from malaria a year, where most of the cases are children under the age of 5 years. Would it not be better to try and save their lives, because they can be helped.
Read more about malaria on http://www.unicef.org/health/files/health_africamalaria.pdf
I believe that since a cure has not been found for HIV as yet,prevention is the better option for now.Yes people might not always abstain from sexual activity but it is the best option.Vaccination is also a good idea but vaccines are not always the answer.(u15097367)
Referring to comment #8, road injuries and diabetes pretty much kill the same amount of people as HIV, with heart failure and strokes being the most prevalent :
In this article what caught my attention the most was that there were some patients that had the CCR5 membrane protein mutation but it had no effect on the functionality of HIV. By developing these treatments are we not increasing the natural selective pressure on HIV? If so, then continued application might only lead to a strain of HIV that is resistant to all treatment types.
I agree. It will be much better for the scientists to invent a vaccine, than to try invent a cure that only kills more people in the process. But I also think that the antiretrovirals have been developed over the years to a treatment that can help patients live much longer with the virus. So I think that if it can be possible to develop a vaccine, it will only be helpful on a long term scale and to eliminate the virus.
As mentioned in a previous comment, Rabies was stopped by vaccinations and not a cure. I feel that with HIV the same can be achieved. Even though there are millions of people suffering with HIV currently, antiretroviral has made the remainder of these peoples lives somewhat manageable. With a vaccination, you ultimately are stopping the HIV in its tracks, unfortunately with human nature comes a lack of responsibility, thus knowing the risk of HIV is real many still do not follow the ABC method and the virus is constantly being spread. With a vaccination this can no longer be possible, and one can only hope that if the vaccination is successful, our great grandchildren will be able to live in a world where HIV isn't a threat.
Looking at where HIV normally occurs, Africa, It would be more economically sound to produce a vaccine rather than a cure. I have heard so many times that even if a cure was available, only the very affluent would be able to access it and therefore the people who need it the most will still be left in the dark. Therefore i think more focus should be asserted on creating a vaccine rather than a cure.
While i agree with most comments on the issue that prevention is better than cure, it is significant to note that there are millions of people currently infected and living with the virus that would disagree with consensus that focus should be on vaccination, the idea of focusing on a vaccine boarders on ethical boundaries while it is logical to “eradicate” the virus for posterity how are their needs more important than the current generation. (#13181620)
Is there any way to find out what co-receptor the HIV uses and then formulate a specific treatment plan according to the result? Or is there a mixture of co-receptors?
Abby, has your blog become some sort of class discussion project for a SA university? You seem to have been flooded by students all debating an issue only tangentially related to the blog post, and appending what seem to be their student IDs to the posts.
On topic: pretty sure this CCR5 gene-editing trials, achieved by a variety of means, are about to go live in the UK. An expensive way to kill your patients if you ask me!
Charl-- Yup! Its happened before, and I asked them to tell me about the class/project, and nobody responded. LOL! But some kids are learning something, maybe, so Ill take it.
I dont have a good feeling about these trials, and I wouldnt personally be involved in one post-infection. Gene therapy that has worked 'works' best when you dont need very good efficiency. The treatment for Hemophilia B, for example. But 'inefficiency' translates into 'minor inconvenience' for HIV. :-/
I don’t agree with the statement that medical scientists should rather put all their time into developing a vaccine than to find a cure for HIV and AIDS. The disease is spread by the people who are infected by the virus (There is a huge percentage of people who are infected by it). Therefore the people must be their main focus and not the vaccine. Because when they are cured the virus will not be able to spread. Vaccine as we all know is not 100% guaranteed the prevent us from been infected. And that’s why they should find a cure.
See? Not gonna clue us in. Leave their required comment and movin on, LOL!!!
It shouldnt be about which aspect should require more time, money or research. The positive results that have been seen in vaccination research have been in my opinion of more ‘scientifc weight’ such as these naturally produced neutralizing antibodies. Creating antibodies and using simple biochemical mechanisms like this gives us an advantage with speed and amount of experimentation that can take place which will then only increase reliability of any results. This should and probably will receive alot more research, more or less, than a cure currently suffering people ? thats for the people with the money to decide…
If finding a cure 5 years from now meant having to proceed with the current methods of treatments then I would be for it. Unfortunately, there is no way to guarantee when a reliable, easily-accessible cure will be found and therefore diverting all efforts strictly to research in that direction (looking for a cure) would be a gamble that could go either way.
Changes need to made on an evolutionary basis.
Seeing as though the AIDS virus thrives in the human body and does not do to well in alternate conditions would it be possible for the inner conditions of humans to be altered for a short period of time in order to kill off the virus ad thereafter return the body back to its original conditions ? For example the virus likes pH conditions between 7 and 8 so altering this may kill it off.
Doesn't the HIV virus replicate itself every time? Its one of the viruses that show that evolution is still happening.
Re #8 and 15:
The only way to "keep silent" an actual vaccine or cure for AIDS would be for everyone involved to be an evil, sociopathic monster. People go into HIV/AIDS research because they care, deeply, about all the people affected by this disease. To imply that they would then 'hide' a cure from the world is whole improbable. Why would anyone do that? A cure for AIDS, a working vaccine for HIV, that's an instant Nobel prize right there.
As someone who spent years working on an HIV vaccine (that didn't work), it makes me really really angry when people imply 1) that it should be easy, and if we haven't found a vaccine by now it's because we aren't working hard enough (#12) 2) that every researcher is some kind of monster, hiding cures from the world.
Wow! This is the closest that they have ever gotten, its unbelievable how no one has found a cure for the disease with the amount of research projects around the world and with most of the top scientists working on the cure, but this just shows how much science has improved over the last few years.
It seem is new knowledge that trials were performed on human beings that were actually infected but was not aware that the experiment resulted in death indicating that this is not a discovery of a possible cure. However this is exciting as science has revealed certain key components such as ccr5 that will draw us not only to a possible HIV vaccine but a way of eradicating HIV completely
How to deal with the SA comments next time they pop up: announce in the comment thread that you have picked 5 people at random (identified by the student numbers they leave), and deleted/withheld their comments (and will do the same to their future comments). Hold these ransom until someone (preferably the course coordinator) explains why they're turning your blog into an HIV101DERP assignment.
On topic: if you're going to do some gene editing for vaccination, surely something like the Farzan work (http://www.nature.com/nature/journal/v519/n7541/abs/nature14264.html) is more sensible?
Against all odds I believe that the invention of a vaccine to this virus would be the best option. I think no one would want to risk the chance of being infected by this virus. Rather prevent it before hand. It is always better to be a step ahead of the disease
I believe that the invention of the vaccination will definitely decrease the number of HIV cases in the world, however, having said that, the vaccination will not be able to cure people who already have the virus.