AIDS ‘cure’ coming—true or false?

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Google the words “AIDS” and “breakthrough” and you get so many promising reports, you can’t be blamed for thinking the end of the pandemic is coming soon.So as World AIDS Day is marked once again on Dec. 1—the first was in 1988—it may be time to take stock.

What the media say

An estimated 34 million people currently have HIV (660,000 of them in Indonesia according to the WHO) and since it’s frightening appearance in the 1980s, some 35 million have died from the virus, making it one of the most destructive diseases in history. It has taken our heroes along with family and friends. So you can’t blame the media for fanning the fire of hope whenever there’s a small advance.

In 2015 there were several hopeful voices, and headlines. For instance, this one from the Washington Post in May: “Breakthrough HIV study could change course of treatment for millions.” Because of their severe, even toxic, side effects, since the 1990s anti-retroviral (drugs which taken in combination or “cocktails,” reduce the viral load, the amount of HIV circulating in the blood) have been recommended only when a patient’s white blood cell count fell to a certain level.

A new study by America’s National Institutes of Health, involving 2,685 individuals in 35 countries, shows treatment appears most effective when you begin at the time of diagnosis. Researchers found that the risk of developing serious illness or death was reduced by more than half—53%—in the early treatment group.

From the Independent in the U.K. came another “breakthrough,” this promising. “New treatment shows extraordinary trial results leading to hopes for more efficient vaccines.” This one claimed that patients injected with a new synthetic antibody reduced the viral load 300-fold.

On the surface, such advances sound pretty good, but as the lead author of the second study, published in the journal Nature, said, “one antibody alone, like one drug alone, will not be sufficient to suppress viral load for a long time because resistance will arise.”

In the India Times, the world’s largest English language daily, Nobel Laureate Françoise Barre-Sinoussi, who co-discovered the virus that causes AIDS, said she believed it was possible that some day people will live with HIV without taking medicine and yet remain healthy and “uninfectious.”  And so it goes.

 

Separating hope from hype

There are three kinds of “cure.”  A sterilizing cure would involve total elimination of all replication-competent HIV. With a functional cure, the virus may not completely vanish, but no replication is detectable and patients experience no disease progression when medication is stopped. Remission is the latest definition to enter the dialog, referring to control of the viral load at low levels in he absence of treatment.

These are the research goals. But as Richard Jefferys of the Treatment Action Group explained in a recent Internet seminar, ”HIV Cure Research—Getting Past the Media Hype,” numerous clinical trials are underway in search of such cures, but none of the interventions currently under study are expected to do the job. An excellent overview of what is being done can be found at http://betablog.org/hiv-cure-research-separating-hope-from-hype/

AIDS and BIMC

While BIMC Hospitals in Kuta and Nusa Dua are not presently equipped to treat HIV patients, it supports World AIDS Day and urges the Bali community to do the same.

 

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BIMC Hospital Nusa Dua
The first hospital in Indonesia with accreditation from Australian Council on Healthcare Standard International  (ACHSI)

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