At least 35 million people around the planet live with HIV, and it kills over 1.7 million people each year, so the fact that it’s currently untreatable is one of the biggest medical problems of our time. But in recent years scientific advances seem to be kicking HIV’s ass more effectively than ever—so is there hope that we neutralize the virus’s threat? The answer is more hopeful than you think.
It’s a big ask, though. You can’t treat HIV easily. It evolves so quickly that any drug you use suffers drug resistance extremely quickly. Instead, you have to work with exotic treatments for patients with longstanding HIV, or try and wipe it out before it’s had chance to act.
Even then, we’d still require a widespread shift in policy and thinking to turn solid research into a practical solution. If history is any guide, turning a scientist’s findings into social and political practice is never as easy as we’d hope. So where, right now, do we stand?
Truth is, we’ve already done it. Back in 2007 Timothy Ray Brown, a 40-year-old HIV-positive patient, was given stem cell treatment for acute myeloid leukemia. Brown was on the brink of death, and the stem cells were a final hope. And the cells he received were from a donor with a rare genetic mutation which confers resistance to HIV infection. Over the course of 20 months following the procedure without antiretroviral drugs, the levels of HIV in Brown’s blood, bone marrow, and bowel became undetectable. A report in 2011 confirmed that he had not relapsed. He had, and still has, beaten HIV.
Finding a cure that can effectively free a person from HIV is tough. It’s not just a case of wiping out the virus—through whatever means you can—but also causing as little collateral damage as possible. After all, the immune system of an HIV sufferer is already on its knees, so the last things it needs is an onslaught which will makes things worse, and that’s never more the case than when a patient has had the virus for an extended period. What’s really required is effective early-stage treatment.
Catch It While You Can
Earlier this year, a child of an HIV-positive woman was treated with antiretroviral drugs just 30 hours after its birth. While the process was a long and slow one—with the infant testing positive for HIV on five separate occasions—the child has now, at age two and a half, been taken off drugs for an entire year and shows no signs of the virus.
Ounces of Prevention
There is, of course, another way. In an ideal world, we’d have a vaccine for HIV, just like we do for measles, tuberculosis and all manner of other diseases. In many ways it’s the cure that matters most. Vaccinate the young and, in a couple of generations time, the virus could be a thing of the past, like polio or smallpox. No surprise, then, that people are keen to find an HIV vaccine that works. And they’re making remarkable progress.
Last year, the FDA approved the first-ever preventative drug for HIV. Called Truvada, it’s what’s known as a pre-exposure prophylaxis, a prevention method that has people who don’t have HIV take a daily pill to reduce their risk of becoming infected. So far, it seems to be working. It’s been shown to reduce the risk of HIV infection by 42 percent compared with placebo in a population of 2,499 patients involved in “high risk” sexual activities, while another trial in 2,400 Thai drug addicts saw a staggering 74 percent reduction. They’re frankly amazing numbers.
The Long Home Stretch
HIV is a tricksy little virus, and it’s well known that it’s able to lay dormant in the body at low levels—and only later become active. So when you read a headline that proudly claims a patient to be cured of HIV, in reality it means that the level of HIV in their system has dropped below a detectable level. That’s still a wonderful thing, but it does mean that, with all of these treatments and preventions, people could still be carrying the virus—and it could at any time rear its head more seriously or even be transmitted. Sadly, there’s little that can be done about that, and for now we’ll have to comfort ourselves with it being as close to a cure as we can get.
Currently, the WHO recommends that HIV treatment shouldn’t begin until each cubic millimeter of a patient’s blood contains fewer than 350 of the white blood cells targeted and destroyed by HIV. But its new proposal is to push that cut-off up to 500. around the globe—slashing the likelihood of disease progression by 50 percent and dramatically increasing the number of people that receive treatment at an early stage.
It’s undeniably one of the most positive policy steps for HIV in recent history. Combine that kind of social thinking with the amazing scientific research that’s being undertaken—three people cured, dozens with HIV abated, and the world’s weightiest computing power crunching the associated numbers—and it’s impossible not to be hopeful. One day, soon, HIV will be dim and distant memory.