With seventh person seemingly cured of HIV, signs of hope for a broader cure | Hacker News Reader

With seventh person seemingly cured of HIV, signs of hope for a broader cure

fiercebiotech.com

14 points_tk_13 comments

What are the signs of hope for a broader cure? That maybe heterozygous mutations work too? It's still a complete bone marrow transplant.

Yeah “seemingly” and “effectively” aren’t enough They are changing laws so if you’re undetectable you don’t have to disclose your HIV status to your partner(s) .. but you could transmit it if you stop taking anti virals or the HIV mutates and then you’ve infected your partners… and just because it’s not detectable how do we know for sure you haven’t transmitted it ?

Seems very wrong.

> just because it’s not detectable how do we know for sure you haven’t transmitted it

We know this unambiguously. If it’s not in your body fluids you can’t transmit it.

We don’t require folks produce a transcript of every VD they ever had to every prospective partner. If the science says not transmissible, that properly takes the matter out of the sphere of public safety and into that of personal trust. (I agree with you that it would seem polite for someone to disclose that.)

> They are changing laws so if you’re undetectable you don’t have to disclose your HIV status to your partner(s)

Do you have a source for this, please?

That’s extremely risky if true. Who’s changing these laws?! Unless it’s fully cured, it should always be listed in someone’s medical history. Crazy! Someone might lie, get married, and after a few months they “forget”, Congratulations, you just destroyed someone else’s life or even your kids.

"destroyed" is perhaps a bit hyperbolic, with these medications HIV now has a better prognosis than diabetes.

https://www.thestar.com/news/canada/supreme-court-clarifies-...

And then one night your partner slips off the condom … then what

If your partner is on medication.. uncertainty, fear, and mistrust.

But for as many medical trials as we've tried, you will not end up with HIV.

If your partner is HIV+, you also are likely on prep. If not, you're probably looking at a course of HIV medication within 48 hours.

So you are looking at a fair number of ways to mitigate, but the actual medical safety is a lower than expected risk.

(The dangerous chance is if you're having sex with someone who doesn't know their positive status, and you don't take other protective measures.)

>They are changing laws so if you’re undetectable you don’t have to disclose your HIV status to your partner(s) .. but you could transmit it if you stop taking anti virals

If you stop taking your medicine, you stop being undetectable, you start being able to transmit it, and you start having a legal responsibility to tell potential partners about it.

What does "cured" mean here ? IIRC, HIV permanently modifies the host cells DNA. Is the DNA somehow reverted back to original in the cured patients?

Bone marrow transplant. All the infected cells die, and the transplant produces new one, free from HIV an. carrying a mutation preventing them from being infected. This approach does not scale.

HIV treatments prevent replication of cells infected by HIV such that the number of immune cells infected by HIV can be undetectable. The problem is there are latent reservoirs of HIV DNA / cells that may reactivate later or hide in areas of the body without immune protection (this is a lot easier for immune system cells with privileged access!). See https://www.nature.com/articles/nrmicro.2015.5 for an older but good discussion on this.

From what I know (which is very little though I follow the news with excitement) HIV is "suppressed" by making it untestably low, which means (apparently) that you are also not contagious. IIRC, therefore maybe you are a carrier, but you experience no symptoms, will not develop AIDS, cannot be proven to be a carrier via testing, and are not contagious. Good enough.

However, in this particular treatment, it was via bone marrow donation, so it literally did change the DNA / body.

From the article:

> For almost six years they’ve tested his blood and other tissues and found no signs of the virus.

Afaict, the researchers themselves don’t know for sure why this has happened.

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