

Australian study points to potential cure for Aids - pwg
http://mg.co.za/article/2013-01-16-australian-study-point-to-potential-cure-for-aids/

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tokenadult
From the article, "Animal trials of the protein are due to start this year,
with any treatment using it likely to be some years away." Well, I'm glad that
got mentioned. Most of the article looks like a minimal rewrite of a press
release. It is way too early for this to be on the front page of HN as "news,"
as there is nothing but speculation here so far. Over the years, I have seen a
lot of press releases about this or that "cure" appear on the front page of
HN, but a few years later, it is discovered that there is neither safety nor
effectiveness in actual human clinical use of the proposed cure. Let's check
in on this again after there have been human clinical trials that have
progressed to actual pre-marketing studies of the treatment.

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crusso
It also mentions that this is a "gene therapy".

That implies a whole mess of biological and regulatory hurdles to jump that
will exponentiate the time before something like this would be available.

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conspiracynutt
this is never going to happen.... its too fucking profitable to have someone
pulling 40,000 dollars of medications for 40 years, that is largely government
subsidized vs. a one time 10,000 dollar fix. i mean yall realize how
outstandingly different those two numbers are right? 40,000 * 40 = 1.6 million
dollars in government subsidized money PER person... vs 10,000.... the former
is literally 16 times more profitable... no way these industries back off that
business model. ( i realize im just guessing at what a one time gene therapy
fix would have to reasonably cost, but you could double it or triple it,
quintuple it and its still significantly less profitable than the former. )

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streptomycin
By that conspiracy theory logic, I'd expect that no pharmaceutical company has
ever done a clinical trial on a gene therapy based cure for a disease. But in
reality... <http://en.wikipedia.org/wiki/Gene_therapy>

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crusso
C'mon, his handle is "conspiracynutt". I think it's probably his job to swear
that there's a drug company conspiracy that aims to prevent finding the cure
for any disease that they can profit from instead.

~~~
27182818284
"novelty accounts" like his should be downvoted on Hacker News, upvoted on
Reddit.

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shiven
Actual citation: <http://www.ncbi.nlm.nih.gov/pubmed?term=23298160>

The full-text article is behind a paywall :-(

The protein these guys are 'mutating' is Tat or 'Trans-Activator of
Transcription' [0], required in the HIV life-cycle for expression of viral
proteins in the infected cells, formation of new viruses and subsequent
infection of more cells. So, basically, they create (mutated) HIV with this
protein that then interferes/competes with 'healthy' ('wild-type' in semi-
correct biologist-speak) HIV in the infected 'patient'. Sounds simple, way
more complex in practice, highly improbable to pull-off as an actual therapy.

(Don't want to bore the _majority non-biologist_ HN audience with more
details. But if HN'ers are interested I'll write more. :-)

My take on this story (always a good idea for spectacular claims) is to take
it with _more_ than a grain of salt. In HN-speak, this is not even a MVP, yet.

[0] <http://en.wikipedia.org/wiki/Tat_%28HIV%29>

~~~
InclinedPlane
I'm not very familiar with viral mediated gene therapy, is it reasonable to
assume that it would be possible to infect enough T-cells with the virus to
overlap a significant portion of the HIV infected cells? And if so, is that
achieved by having the viral vector spread rapidly as well? Wouldn't that be
nearly as damaging as the HIV infection to start with? Or is the goal to try
to introduce entire modified HIV genomes into cells and then have those be
fortuitously replicated and bound into HIV particles which will hopefully go
out and re-infect other T-cells and in the process inhibit the HIV production
rate?

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shiven
HIV, being a retrovirus, acts by inserting its genome into the infected cell's
nuclear DNA. The infected cell is unable to distinguish it from its own
'native' DNA. This is a fundamental aspect of how the cellular machinery is
hijacked by the virus to replicate itself.

Now, nearly a tenth of the human genome is made up of retroviruses (ERVs) that
got inserted into our genome over the course of our species' (rather short)
evolutionary history [0]. These ERVs were rendered dormant by genomic
silencing of entire swaths of the genome (by mechanisms too detailed to go
into here) turning them into 'harmless', silent blocks of genetic code we now
carry in every cell!

 _is it reasonable to assume that it would be possible to infect enough
T-cells with the virus to overlap a significant portion of the HIV infected
cells?_

That is the basic assumption, but is not guaranteed to happen. Specifically
because a sub-population of infected T-cells, called the 'reservoir'
population, are 'sleeping' in the bone marrow or the brain (and numerous other
organs), waiting for signals from the immune system to activate them into
action, which may happen due to an unrelated infection (or other reasons).
This sub-population of cells, once called into action, will start running
their usual gene expression program, resulting in the production of new
viruses and infection of new cells. This is the NP-hard problem of HIV
therapies!

 _Or is the goal to try to introduce entire modified HIV genomes into cells
and then have those be fortuitously replicated and bound into HIV particles
which will hopefully go out and re-infect other T-cells and in the process
inhibit the HIV production rate?_

In a word, yes. But there are too many moving parts to have the whole shebang
fly off the handle and cause unintended or unexpected actions. Gene therapy,
in its current form, has its place in the pantheon of medicine, but HIV is
probably not a very good problem to attack with this approach, partly for
reasons I mentioned above. The future of gene therapy holds the definite
promises of _miracle cures_ , which will be possible after more research and
development (but only made possible by your tax dollars) ...

[0] <http://en.wikipedia.org/wiki/Endogenous_retrovirus>

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xutopia
I'm surprised by the use of "potential" in the title. Most times we hear there
is a cure and that we should all rejoice.

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darkxanthos
The article states "...not a cure..." for HIV. Rather it may cause HIV to
become latent and not develop into Aids.

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ceejayoz
That still makes it a cure for AIDS.

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darkxanthos
It makes it a prevention for Aids. If you already have Aids it won't cure it.

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tsotha
Hard to imagine how it wouldn't cure Aids if the virus can't replicate.

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NamTaf
Here is the original press-release from QIMR:
[http://www.qimr.edu.au/page/News__Events/Media_Centre/Media_...](http://www.qimr.edu.au/page/News__Events/Media_Centre/Media_Releases/QIMR_research_turns_HIV_on_itself/)

FYI, QIMR is a government-funded research facility for medical research and is
incredibly well-respected here. They have a major cancer research facility
attached to one of the best hospitals here. QIMR (with the University of
Queensland - another big medical research entity here) also perform their own
phase 1 and phase 2 clinical trials.

In short, these guys are a juggernaut of medical research here and it's
entirely possible that this will see tangible results in the middle-future.

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brianbreslin
As a non-scientist can someone explain how this would be delivered? How do you
do gene therapy on a virus already in people? I guess more ignorantly, how
does one deploy the cure to all of the HIV cells in the body in order to
modify them?

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crusso
I was going to shoot off "with a retrovirus", but then I thought I'd wikipedia
it. Glad I did. Looks like the non-viral delivery methods are improving.

<http://en.wikipedia.org/wiki/Gene_therapy>

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conspiracynutt
nullbasic? honestly sounds like bullshit... im starting to think that all of
this AIDS "research" is bullshit. theres too many declarations of cures....
also where are all the people with AIDS in the developed world... if this is a
huge epidemic and millions of people remain untested... then there should be a
huge amount of people getting the weird AIDS illnesses they did in the 80s (an
untested person should progress to AIDS... this is not happening with any
regular occurrence)... condoms, treatment, or not... there should be lots of
AIDS patients. especially if millions of people are dying. I've been to
African slums. i don't see that. something is super fishy with this industry.

