HIV Science

While headlines from around the world may have made some outstanding claims, the truth is that there isn’t a cure for AIDS – yet! The good news is that all of the patients over whom the fervor has been started over have something in common – they’re all still alive and no longer require treatment. That may sound a lot like they’ve been cured, but there is a the difference.

While all the patients were diagnosed with HIV and treated with antiretroviral drugs, the disease had not yet fully penetrated their bodies’ defenses – the drugs were able to thus act as a defense mechanism to keep the virus from spreading as it usually does. Once those defenses were in place, they could come off the drugs.

So aren’t they cured? No – but they no longer require continued treatment, and that is a huge advancement. Does this mean that we will see HIV patients across the globe coming off of their antiretroviral treatments? Definitely not – unfortunately, the number of patients who would survive when coming off the treatments would be relatively few, and it’s very difficult to know which ones would survive and which ones would suffer rapid progression of the disease. Of course, it’s a chance very few doctors will be willing to take with patients in their care.

However, these events may result in some policy changes when it comes to AIDS. For one thing, people generally need to decide on their own to go somewhere and get tested in order to find out they have the disease. Very few are early enough on in the disease to experience the results of these patients who no longer require treatment. This places the burden on health agencies to seek out high-risk individuals and encourage testing so that the disease can be caught early.

The other adjustment needs to occur on the side of the patient. Many who discover they are HIV positive drag their feet about starting a treatment plan – this needs to stop, as it may make the difference between early treatments stopping the spread of the disease completely, and merely being able to slow it down.

Why should a person with HIV seek treatment immediately? Here are three benefits of catching the disease early and starting an antiretroviral regimen at the first possible opportunity:

1. They may possibly be able to prevent the need for treatment later on.
2. It may lead to an increased lifespan.
3. Risk of spreading the disease decreases by up to 96%.

This is why researchers are calling for the health industry to seek out and test individuals who are in the highest risk categories. Early detection is the key, because HIV hides in the immune system, actually becoming part of the DNA of certain white blood cells. Once this occurs, it isn’t long before the disease spreads to the lymph nodes, bone marrow, and other areas of the body, where it becomes difficult to control and is seemingly impossible to eradicate.

The widely-reported American who received treatment in Berlin was actually getting treatment for leukemia (blood cancer), and the treatment involved bone marrow transplants. He had already been receiving HIV treatments for over a decade, and had to have his bone marrow completely irradiated and replaced. The donor marrow had a rare mutation that made HIV target cells impenetrable to the disease. The result was that he no longer needed his HIV treatments. The disease isn’t cured, but it can no longer spread.

In the United States, the same treatment was repeated on a boy who was being treated for leukemia and is also HIV positive. It will take some time before it is known whether or not the treatment achieved the same effects for this boy as it did for the Seattle native that was treated in Berlin.

The baby who appeared to be cured had a completely different scenario. Full treatment began just over a day after the HIV positive baby was born, although such aggressive treatments are not given until later as a general rule. Treatment continued for one-and-a-half years, when the mother stopped treatment.

After 5 months the baby was tested and seemed to be HIV free. It is now 3 years old. While the baby seems cured, many are skeptical and believe the HIV sequence has simply been buried too deep for testing on such a living person to be viable. Either way, there is no apparent further progression of the disease or need for treatment.

The French patients who stopped their treatment were all part of a group that were started on antiretroviral drugs within weeks or months of contracting the disease – they all continued on the regimen for at least a year, and only about 1 in 7 patients were able to successfully stop their treatments at the end of the study.

So far, scientists can only speculate on why one patient may be able to stop treatment while others need treatment indefinitely to halt the disease. Some have posited that it must have something to do with certain strains of the virus being weaker, while others believe it may have something to with an increased number of CD4 cells in the patient. The problem is that studying the potential for a cure further requires HIV patients who have been recently infected – while scientists don’t have a problem intentionally infecting monkeys to run trials, this would obviously be out of the question for human trials.

Ultimately, HIV is at this point not cured. On a positive note, stopping the spread of the disease across the body is now a much more feasible goal – it has been done by accident, and even on purpose a few times. The trick now is to find a process that guarantees successful treatment instead of relying on poor odds.