Not there yet, but cause for hope...

March 17, 2013 7:57 AM

Fourteen adults have also been "functionally cured" after they were given combination antiretroviral therapy (cART) for their HIV infection. [Warning: autoplay] They have been able to stop taking the treatment while still keeping their infection under control, according to a new study in the journal PLOS Pathogens.

There is an important distinction between 'functionally cured' and 'HIV negative'.

MedPageToday pointed out that while the 14 adults still technically have HIV in their bodies, it's only barely detectable when using highly sensitive laboratory methods. Therefore, they are considered "functionally cured" instead of being completely rid of the virus....

The findings suggest that anywhere from 5 to 15 percent of people are able to be "functionally cured" of HIV, the study researcher, Dr. Asier Saez-Cirion, told BBC News.

"They still have HIV, it is not eradication of HIV, it is a kind of remission of the infection," Saez-Cirion told BBC News.

In other words, it's too soon to know yet if these individuals can still transmit HIV to others (though at least the likelihood of transmission would be lowered), and 85-95% of infected adults in the study were not functionally cured.

This report follows that of a baby who was pronounced functionally cured of HIV recently (previously). Some skeptical researchers noted that, while the baby was certainly exposed to HIV, there's some doubt about whether the child had been infected with HIV:

In the case of the Mississippi baby, we know she was exposed to HIV, had HIV in her blood, and that at least some cells in her blood were found with sleeping virus—though we will likely never know if those cells were from the child or maternal cells that had been transmitted during pregnancy or birth. Was the baby infected with HIV and, thus, cured?

To many of the researchers at the conference, the answer is "no." It seems more likely that her treatment prevented her, after exposure to HIV, from being infected. The reason we give medicines to both pregnant women and their newborns is precisely to prevent HIV exposures in children from becoming established infections, an intervention that can decrease the rate of transmission from about 30% to less than 1% in optimal conditions.

posted by eviemath (10 comments total)

85-95% of infected adults in the study were not functionally cured.

If there were 70 people in the study, and fourteen were functionally cured, 56—that is, 80%—were not functionally cured.
posted by kenko at 8:04 AM on March 17, 2013

Great news! I hope this will soon lead to therapies that can fully cure HIV sufferers, and to higher rates of success. Still, this is cause for celebration! And it's published open-access, too!
posted by Scientist at 10:07 AM on March 17, 2013 [2 favorites]

related: we're at the 30-year anniversary of Larry Kramer's fiery wake-up call to gay men, 1,112 and Counting.
posted by roger ackroyd at 10:51 AM on March 17, 2013 [3 favorites]

I came of age just after AIDs awareness hit the mainstream - and our sex ed was all condoms or death. It was scary - but we needed to be scared because it made us safer (though still not always safe enough - but still safer). I worry so much more about younger people - especially younger men who sleep with men (MSM), because I read recently that some 60% of new HIV infections are among MSM. Considering the relative population numbers, that stat freaked me out. I don't want to see the 80s happen again.

This is hopeful and I'm happy - but we can't let slip efforts to education on how to practice safe sex for all people.
posted by jb at 10:52 AM on March 17, 2013

Is it just me, or do these breathless reports of a cure for HIV show up every few weeks? The ones about the baby were particularly egregious, for the reasons mentioned in the FPP. I feel like anyone who knows a little bit about mother-to-child transmission could point out the problem with the reporting there.

Look, I'm not dismissive about peoples' hopes for a cure. I do empowerment work with young girls in South Africa, where it was recently reported that a third of schoolgirls are likely HIV+ in areas like the one where I work. I have close friends who are HIV positive. It's heartbreaking. But now when I see new reports of some miracle cure my first reaction is to ignore it, because they always seem to turn out to be terribly over-exaggerating. It's like the boy who cried wolf. I wish there were more responsibility about this kind of reporting, and headlines were more cautionary about declaring HIV "cured". Sorry, maybe that makes me sound like a grump.
posted by Solon and Thanks at 11:18 AM on March 17, 2013 [3 favorites]

I should add: I do appreciate the way this post was framed, more thoughtfully than the way these reports have been framed elsewhere. I suppose I'm just speaking out of a place of discouragement, but I'll keep up hope all the same.
posted by Solon and Thanks at 11:28 AM on March 17, 2013 [1 favorite]

Regardless of how it's been reported, I think these stories are popping up because there's been a lot of news on the HIV front lately, and all of it's promising. The Berlin Patient news is still fresh in my mind as well.
posted by Peevish at 12:27 PM on March 17, 2013 [1 favorite]

On a related note, bees join the war on HIV: Nanoparticles loaded with bee venom kill HIV.
posted by khonostrov at 2:45 PM on March 17, 2013 [2 favorites]

Is it just me, or do these breathless reports of a cure for HIV show up every few weeks?

It's important to read the papers instead of relying on press reports. Always read the papers. The paper at issue is "Post-Treatment HIV-1 Controllers with a Long-Term Virological Remission after the Interruption of Early Initiated Antiretroviral Therapy ANRS VISCONTI Study" which mainly calls the state of these patients "remission" and puts it as a milestone towards a "functional cure." I think this is result is a big deal, but it's pretty hard to see what is and isn't from reading the popular press.

we're at the 30-year anniversary of Larry Kramer's fiery wake-up call to gay men, 1,112 and Counting.

Most of these “distinguished” publications, however, will not publish anything that has been spoken of, leaked, announced, or intimated publicly in advance. Even after acceptance, the doctors must hold their tongues until the article is actually published. Dr. Bijan Safai of Sloan-Kettering has been waiting over six months for the New England Journal, which has accepted his interferon study, to publish it. Until that happens, he is only permitted to speak in the most general terms of how interferon is or is not working.

Priorities in this area appear to be peculiarly out of kilter at this moment of life or death.

And 30 years later, that still hasn't changed for journals like the New England Journal of Medicine.
posted by grouse at 2:45 PM on March 17, 2013 [1 favorite]

My personal experience is with cancer, not HIV, so my notions are only sympathetic. For now, I'll settle for remission. If I can hang in there, I may be around when they come up with a vaccine.

The thing about stats is that you don't get to pick which part of the "survival" curve you'll be on.
posted by mule98J at 9:50 AM on March 18, 2013 [1 favorite]