Is a cure for HIV within sight? UNAIDS seem to think so. Their Executive Director Michael Sidibé stated that as long as research is maintained a cure for HIV can be found within the next decade. ‘How far are we?’ he asked himself in an interview last year, ‘I personally feel that a cure is not so far, a functional cure is possible probably in the next 6 to 10 years’. His sentiment was echoed by the group of 30 or so international scientists who developed a global scientific strategy called ‘Towards an HIV cure’ last year. Whether you feel his optimism is realistic or exaggerated one thing that’s beyond doubt is that research has shown great progress towards finding a possible cure for the disease, particularly since the turn of the century.
Even before that, however, at the start of the 1990s, research began indicating the possibility of a cure for HIV. A controversial study published in the journal Nutrition claimed that vitamin C could suppress HIV virus activation. It was part of a flurry of research into the role of vitamin C as HIV treatment, studies that were often greeted sceptically. One of the reasons was that results in different research were often contradictory and failed to clearly show the role of the vitamin in the immune system. Also, most of the evidence that taking supplements of vitamin C can delay progression or improve survival in people with HIV is based on test tube (in vitro) studies. The practicality of using vitamin C has also been questioned by some studies that have pointed to the dangers of high doses which may cause cell damage and kidney stones. Jariwalli, who wrote the Nutrition study, defended the study saying that the reason more research hasn’t looked at vitamin c is because of the disbelief of it’s potency and the fact that vitamins are not patentable, so presumably, there was no opportunitiy to make money using vitamin C as treatment.
What about more recent research? One of the most publicised is the so-called ‘Berlin study’ where Timothy Ray Brown, an HIV positive man who had leukaemia, had a bone marrow transplant. Stem cells were transferred from a donor and resulted in the apparent eradication of the HIV virus in the patient’s body. The donor was chosen specifically because he had a relatively uncommon mutation meaning that he had been less receptive to HIV. Over 5 years after the operation Timothy appears to have been cured – not only does he have an undetectable viral load but doctors say it also appears possible for him to become infected with HIV again. Whilst stem cell treatment might be possible in certain ciscumstances it is currently very expensive and not a pleasant treatment, particularly when combined with chaemotherapy so its use outside very particular situations seems limited.
Timothy Ray Brown following pioneering treatment to eradicate HIV
Using a different approach, an Australian study published this week also increases the hope that we are a step closer to finding a cure for HIV. Researchers at the Queensland Institute of Medical Research have pioneered gene therapy that works by changing the genetic structure of HIV, effecitvely turning it into a ‘weapon’ against itself, which has been called ‘Nullbasic’. The proteins that make up the HIV research can be blocked, preventing the virus from damaging the immune system. Not only does this hold possibilities for curing HIV but it might also help preventing the spread of other viruses too. Another promising approach is research focused on viral latency. HIV is difficult to cure partly because the virus can remain latent in T-cells and other cells long term and if they are reactivated production of the virus can resume. Research is currently being conducted into reactivating cells and then ‘flushing them out’ making the HIV virus vulnerable to antiretroviral drugs and the body’s natural immune response.
For the moment the hope of a universally effective and inexpensive HIV cure remains just that. Nevertheless, one thing is for certain, we are much further down the road towards finding a cure than we were at the start of the 21st century. Although more work need to be done, research into improving the life quality of those with HIV and finding a cure have made great advances indicating that an HIV cure in the near future, if not within 6-10 years as Michael Sidibé claims, then within the next generation, is a very real possibility.
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