
More HIV 'cured': first a baby, now 14 adults - danboarder
http://www.newscientist.com/article/dn23276
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carbocation
These people are not cured.

> The 14 adults still have traces of HIV in their blood, but at such low
> levels that their body can naturally keep it in check without drugs.

For a transmissible infectious disease with a reservoir, cure means
eradication. These people appear to have one of the following (just my
guesses):

1) Early HAART led to selection pressure on HIV in such a way that, for some
people, the HIV itself that became embedded in the latent reservoir is
defective in some way. Therefore, the reservoir continues to produce HIV
particles, but these are relatively ineffective at infecting additional cells.

2) They are supercontrollers via a previously undescribed mechanism (since
they were stated not to be classical supercontrollers).

Again, this is complete speculation that would require sequencing and
functional studies to investigate, HIV is not my field, etc.

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tokenadult
From the article:

"Asier Sáez-Cirión of the Pasteur Institute's unit for regulation of
retroviral infections in Paris analysed 70 people with HIV who had been
treated with antiretroviral drugs (ARVs) between 35 days and 10 weeks after
infection – much sooner than people are normally treated.

. . . .

"Most of the 70 people relapsed when their treatment was interrupted, with the
virus rebounding rapidly to pre-treatment levels. But 14 of them – four women
and 10 men – were able to stay off of ARVs without relapsing, having taken the
drugs for an average of three years.

. . . .

"On average, the 14 adults have been off medication for seven years. One has
gone 10-and-a-half years without drugs. 'It's not eradication, but they can
clearly live without pills for a very long period of time,' says Sáez-Cirión."

Any time I hear of someone not finding that an HIV infection turns into an
early death after debilitating illness, I'm glad to hear the news. And if some
commonality of those patients can be discovered that provides a clue how
better to treat other patients, so much the better. But those odds (the
majority of the patients who ceased treatment finding their infections
rebounding back to acute clinical disease) are still discouraging. For AIDS,
an ounce of prevention is still worth a pound of cure. The cases described
here sound less like a "cure" than the case of the baby from Mississippi
reported earlier, as these patients still have detectable HIV infections, just
not infections currently resulting in clinical disease.

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powertower
"Functionally cured" is the key phrase in that article. They still have the
HIV virus. But their immune system keeps it in check.

That last part I don't understand. At that point, isn't it just a fine balance
that can tip over at any point in the future, were the virus can come back
stronger? Like if the person gets a cold, or the immune system get's weakened
somehow (even for just a short time).

~~~
alecdbrooks
I'm guessing the balance isn't that fragile because the people in question
have had been drug-free for seven years on average. They must have had some
minor illness during that time period.

------
danboarder
"Last week, a baby was reported to have been 'functionally cured' of HIV after
receiving a three-drug regime of ARVs almost immediately after birth."

I'm curious about the qualifier "functionally cured" and what this means
exactly.

The basic idea I gather from the article is that unusually early drug
treatments have been found to 'cure' people of HIV in this way, where they no
longer need drug treatments.

~~~
tedivm
The hint is in what they said about the adults-

>The 14 adults still have traces of HIV in their blood, but at such low levels
that their body can naturally keep it in check without drugs.

They still have HIV, and it may develop into AIDS again later. They can also
still spread it, since they do have it in their system. They just don't have
enough of it to cause them problems.

With the baby there supposedly aren't any traces, but it's perfectly possible
that there are still packets of the virus present. There is no definitive way
to know the virus is completely gone and won't come back later.

~~~
pekk
So they feel great, don't need medical treatment, but can still spread it to
others... so great, maybe here we go with AIDS becoming as common as the flu
(and mutating more, and killing poor people who can't afford the expensive
therapies)

~~~
shantanubala
Is there a reason why you think that? It will probably still be sexually
transmitted (so it can be avoided more easily than the flu), and it already
has a much worse impact on poorer communities. Also, you are assuming that the
treatment will remain expensive forever and that there won't be any
preventative treatments available in the future.

~~~
yk
Perhaps he is thinking of Gibsons's Bridge trilogy. There AIDS is cured by
finding a variant of HIV which does not cause the disease. And at least in one
scene it is implied that infection with the harmless variant is a usual
prerequisite for casual sex.

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guelo
> The 14 adults still have traces of HIV in their blood, but at such low
> levels that their body can naturally keep it in check without drugs.

That doesn't sound like cured to me since they're probably still infectious
even if they aren't getting sick from it.

~~~
UnoriginalGuy
You aren't wrong, but by that logic are we ever really cured?

I mean you "kill" cancer: But yet cancerous cells likely remain either in the
general area of the tumour or in your blood stream.

You get "cured" of a deadly disease, but many continue to remain in your body
for sometimes the remainder of your life.

~~~
netrus
Yeah, but cancer is not infectious. People will always develop cancer, but we
could potentially get to a point where nobody has HIV anymore, if we can
prevent the virus from spreading.

~~~
geuis
Not disagreeing with you since as far as I know, there are no human cancers
that are contagious. There are at least 2 mammalian cancers I know of, and
possibly more, that are contagious. One is a disease wiping out Tasmanian
devils. Another is a sexually transmitted cancer among dogs. Its thousands of
years old and shows up as small tumors around the genital regions of affected
animals. There was a TED talk describing this in some detail. Don't have the
time to search for a link at the moment, but you can probably find it.

~~~
jeza
Well there's human papilloma virus
(<http://en.wikipedia.org/wiki/Human_papillomavirus>) which can result in the
development of cervical cancer
(<http://en.wikipedia.org/wiki/Cervical_cancer>).

~~~
tsotha
There are probably all sorts of viruses that can _cause_ cancer. But that's
not the same thing as actual infectious cancer cells.

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liquidcool
This caused me to look up the Timothy Brown case, the man who was cured of
AIDS via a bone marrow transplant for his leukemia with cells from a
supercontroller. I get the concept of remission for the patients in the New
Scientist article, but this article has Brown claiming he's completely cured:

[http://www.webmd.com/hiv-aids/news/20120724/man-cured-of-
aid...](http://www.webmd.com/hiv-aids/news/20120724/man-cured-of-aids-virus-
news-conference)

If true, it gives hope that a complete cure is possible.

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p6v53as
This is quite an achievement to go from no cure whatsoever, to a cure that
works on 1% of people. Because now you don't need to look for things that
works, you need to improve something you have.

