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Comment by ruined | Hacker News Reader

hsv may have a broader market, but there is clearly a greater social benefit and urgency to new hiv treatments. hsv infection is essentially a minor annoyance compared to hiv which can be life-changing and lethal.

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HSV is, iirc, one of the most significant causes of serious conditions like viral encephalitis. I wouldn’t be surprised if the net impact were similar to or greater than an HIV cure, considering that about 5,000x more people have HSV than HIV (order of magnitude estimate from a quick look at some stats I found online). Of course, the PR of an HIV cure is much better.

hsv encephalitis incidence is like 2 per million which is absolutely incomparable to hiv infection which has rates as much as 1 in 5 in some high risk populations and 4930 per million globally. the net impact of a new effective hiv treatment is indisputably more significant.

> hsv encephalitis incidence is like 2 per million

This can’t possibly be correct. It’s the most commonly diagnosed etiology for viral encephalitis, which definitely occurs more than a single digit per million. It’s also going to be underdiagnosed because the diagnostics are bad (fewer than half of encephalitis cases are assigned an etiology). I see several sources saying in the range of 2-4,000 confirmed HSV encephalitis cases per year in the US (which are usually extremely severe, leading to brain damage or death), compared to 5,500 “HIV-related” deaths per year in the US according to the CDC. So at the very least they seem similar in magnitude.

HIV is very manageable with drugs, and life expectations are very high. Whilst the disease is horrible, and we should be seeking a cure, its manageable. HSV is emerging as one of the biggest contributors to dementia. That is itself a disease that kills - just over a longer time span. Unfortunately for HSV there is little long term strategy for management that can address this issue. The *ciclovir drugs primarily target viral shedding, and not the rest of the infection cycle.

I'd be very surprised if the long term cognitive effects of HSV were greater than HIV even with modern drugs.

It takes non trivial logistical efforts to deliver HIV drugs to people. Think folks living in slums in south africa, homeless drug users in the USA, etc.

Around 680k people died of AIDS related illnesses in 2020 alone. https://www.unaids.org/en/resources/fact-sheet

Also the number of HIV infected people is still increasing.

https://www.avert.org/global-hiv-and-aids-statistics

According to Crunchbase*, Excision received $70M in investment. A meagre amount of funding for the causes Excision is working on.

* https://www.crunchbase.com/organization/excision-biotherapeu...

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