cure for HIV?

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bigballer27

bigballer27

That's what she said
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Amazing story!

About your inquiry; it seems to be that in order to create some type of immunization, they would have to probe the bone marrow of the 1% of the caucasians who are immune, which sounds pretty dangerous. In the first place, are there any tell-tale signs that someone is immune?
 
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why would the pharmaceutical industry want to create the cure for hiv/aids when all these anti-retroviral drugs are making an insane profit for them?

gotta love capitalism :/
 
I have trouble believing that pharmaceuticals are some how hindering the progress of drugs. I mean nobody was stopping for the polio vaccine from being created.
 
bajastapler said:
why would the pharmaceutical industry want to create the cure for hiv/aids when all these anti-retroviral drugs are making an insane profit for them?

gotta love capitalism :/
Click to expand...



haha yeah, pretty crazy how capitalism can control people's lives....who knows, maybe it's the same story for cancer...
 
It looks like the people that are immune to HIV are immune due to some specific gene rather than previous exposure to HIV. That means that any cure would have to be a gene therapy cure, not an immunization. I think that's what is making it so difficult (read: pointless) to do a ton of research into it right now.
 
When will the headlines read: cure for heart disease.
 
Astarael said:
It looks like the people that are immune to HIV are immune due to some specific gene rather than previous exposure to HIV. That means that any cure would have to be a gene therapy cure, not an immunization. I think that's what is making it so difficult (read: pointless) to do a ton of research into it right now.
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:thumbup:

No offense, but isn't this story kind of old? I could have sworn I read about this in the NYT a couple of years ago.
 
CoolWhipp said:
Not really.

http://www.fiercepharma.com/story/gileads-us-pricing-hiv-meds-draws-fire/2011-05-12
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I really like that article :), but i'm a little confused as to what your point from it is. this is what I got from it:

"And even though healthcare reform and other factors may be pressuring U.S. prices, the American market still bears higher drug costs ... (a) commonly used three-way combo drug, (still) costs more than $20,000 per year."

What I'm getting from this article is that lobbyists and interests groups are trying to pressure pharma companies to lower drug costs in the u.s. Despite these pressures, however, drug costs still remain high.

All I was trying to say is that as long as pharma companies can continue to make gradual improvements/patents to the current drug regime there is no need to heavily invest in the HIV cure. Once it exists, there would be an epic political sh*tstorm - both in the u.s. and globally - that would ultimately void the patent and make it commercially accessible to people of all socio-economic statuses. The cost-benefit of making such a cure-all is abyssmal. I'd love to have an open talk about this more & cite articles :) but after my finals week. -____- hahah
 
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Oh my god... Reading the comments on that story...seriously want to face palm.

"Why can't they just replicate the part of the bone marrow that cures HIV?? seems like science can do that..."

:wtf:
 
LaFleur said:
:thumbup:

No offense, but isn't this story kind of old? I could have sworn I read about this in the NYT a couple of years ago.
Click to expand...

Yeah, it's definitely old. Not sure how old, though.
 
Astarael said:
It looks like the people that are immune to HIV are immune due to some specific gene rather than previous exposure to HIV. That means that any cure would have to be a gene therapy cure, not an immunization. I think that's what is making it so difficult (read: pointless) to do a ton of research into it right now.
Click to expand...

this.
 
The 1% of Caucasians who are immune have a deletion in CCR5, which is a chemokine receptor that HIV (the most common strain of it [R5 tropic]) uses to enter immune cells.

A vaccine is problematic because 1) a traditional vaccine can't make your immune system attack what it already recognizes as a self antigen, 2) attacking your cells that express CCR5 would kill your immune system.

One CCR5 inhibitor has been thus far approved by the FDA for (treatment-experienced) HIV patients - maraviroc (Selzentry, by Pfizer). Efficacy and safety has been demonstrated in double blind controlled trials. (Look up "MOTIVATE")

Also, marrow transplants are very risky. Since HIV can be well-controlled with antiretroviral therapy, curative transplants are not worth the risk. The man in the story got the transplant primarily because he had leukemia.
 
MeowMeowCAT said:
I have trouble believing that pharmaceuticals are some how hindering the progress of drugs. I mean nobody was stopping for the polio vaccine from being created.
Click to expand...

. The polio vaccine was created under the thematic element known as therapeutic optimissm and Vannevar Bush's search for the magic bullet. I agree that no one stopped the polio vaccine from being created. But since then a lot of things have changed and have been exploited
http://www.nsf.gov/od/lpa/nsf50/vbush1945.htm

Since the polio vaccine, an insane amount of new drugs have hit the pharma market. Many are designed to make a profit and provide minimal benefits. One of these profit induced drugs was thalidomide. It had terrible birth defects, but was still pushed in many countries to make a profit.

Iono where I'm really going with all of this or why I'm even arguing. lol. I guess I just want people to consider that everything has an agenda & that everything isn't so black and white :)
 
Isoprop said:
When will the headlines read: cure for heart disease.
Click to expand...

It depends. If it's a disease be stopped with exercise and a good diet, as soon as people understand the consequences of their actions.

However it's something solely genetic, like ARVD which runs in my family, who knows?
 
AntiHouseMD said:
It depends. If it's a disease be stopped with exercise and a good diet, as soon as people understand the consequences of their actions.
Click to expand...

According to Luc Montagnier, AIDS is something that can be cured with a good diet :(:scared::scared::wow::uhno::wtf:


Unfortunately, the Nobel Prize Disease has struck again.
 
lindablee said:
Oh my god... Reading the comments on that story...seriously want to face palm.

"Why can't they just replicate the part of the bone marrow that cures HIV?? seems like science can do that..."

:wtf:
Click to expand...


I agree....
 
chronicidal said:
The 1% of Caucasians who are immune have a deletion in CCR5, which is a chemokine receptor that HIV (the most common strain of it [R5 tropic]) uses to enter immune cells.

A vaccine is problematic because 1) a traditional vaccine can't make your immune system attack what it already recognizes as a self antigen, 2) attacking your cells that express CCR5 would kill your immune system.

One CCR5 inhibitor has been thus far approved by the FDA for (treatment-experienced) HIV patients - maraviroc (Selzentry, by Pfizer). Efficacy and safety has been demonstrated in double blind controlled trials. (Look up "MOTIVATE")

Also, marrow transplants are very risky. Since HIV can be well-controlled with antiretroviral therapy, curative transplants are not worth the risk. The man in the story got the transplant primarily because he had leukemia.
Click to expand...

This post is not getting nearly enough attention. :(

Basically, this was only even feasible because the guy had leukemia already. Marrow transplants are extremely hard on the body and can lead to horrible long term effects, even with a good match. Graft vs Host disease can be absolutely horrifying. This still leaves out that to prep for a marrow transplant, you must ablate the host's marrow using full body radiation and chemotherapy agents. After that it takes months before the host's new immune system is functional enough for the person to survive outside of controlled conditions.

There is some research being done (I'll post a link later if I remember) that is attempting to insert the CCR5 delta32 mutation (the one that confers HIV resistance) to a patient's own PSCs and then autologously grafted back into the patient. This currently would still be a pretty daunting and expensive treatment...

Even more promising, in my opinion, is the virus vs virus approach...look up Louis Picker from OHSU.
 
bucks2010 said:
u jelly?
Click to expand...
96420ca1-b6af-4cc2-b092-bbf82fa44c7a.jpg
 
HINKLO said:
This post is not getting nearly enough attention. :(

Basically, this was only even feasible because the guy had leukemia already. Marrow transplants are extremely hard on the body and can lead to horrible long term effects, even with a good match. Graft vs Host disease can be absolutely horrifying. This still leaves out that to prep for a marrow transplant, you must ablate the host's marrow using full body radiation and chemotherapy agents. After that it takes months before the host's new immune system is functional enough for the person to survive outside of controlled conditions.

There is some research being done (I'll post a link later if I remember) that is attempting to insert the CCR5 delta32 mutation (the one that confers HIV resistance) to a patient's own PSCs and then autologously grafted back into the patient. This currently would still be a pretty daunting and expensive treatment...

Even more promising, in my opinion, is the virus vs virus approach...look up Louis Picker from OHSU.
Click to expand...


I would like the link. Inserting the a mutation would still lead to foreign peptide expression and rejection, so I'm interested in seeing how that would work.
 
CoolWhipp said:
I would like the link. Inserting the a mutation would still lead to foreign peptide expression and rejection, so I'm interested in seeing how that would work.
Click to expand...

this is true. the complexities of the immune system...
 
CoolWhipp said:
I would like the link. Inserting the a mutation would still lead to foreign peptide expression and rejection, so I'm interested in seeing how that would work.
Click to expand...

Ask and ye shall receive. I did a little bit more digging, and it looks like people are focusing more on drug-based knockouts rather than gene therapy for now until more effective and accurate "brute force" therapies like maybe RNAi are available. The only thing I could find for direct alterations of genes was in mice, and not tested against a murine equivalent of HIV. Anyway, here are a couple sources...I couldn't find a free full version of the paper, but the abstract (as a good abstract should) gives you a pretty good idea of what's going on if you already have a basic understanding of HIV pathology.

http://journals.lww.com/co-hivandai...mokine_receptor_5_knockout_strategies.14.aspx

http://iasusa.org/cme/2010-fnewyork/syllabus/syllabus.pdf#page=21
 
bajastapler said:
why would the pharmaceutical industry want to create the cure for hiv/aids when all these anti-retroviral drugs are making an insane profit for them?

gotta love capitalism :/
Click to expand...

bigballer27 said:
haha yeah, pretty crazy how capitalism can control people's lives....who knows, maybe it's the same story for cancer...
Click to expand...

Wow, you guys are ****ing brilliant. :rolleyes: You've got it all figured out! :thumbdown:
 
Few things:

-Bone marrow transplants might be more dangerous than having HIV. HIV can be controlled so as to make it a chronic condition now. It still sucks, but it's no longer a death sentence and never has to go to AIDS.

-If you're talking about Elite Controllers, i.e. those that get HIV but will never get AIDS even without drugs, then you can induce their mutation in people, but why would you? Would you want to make the entire worlds population susceptible to the next virus that runs through? You're just changing the cell binding protein.

-The saddest thing about HIV is that mother to child transmission is pretty much completely preventable, but so many people aren't tested and don't get the drugs that would effectively stop transmission.

-The other neat research going on is in PrEP (pre exposure prophylaxis). This has been shown to be effective in gay men, but the heterosexual trials were stopped early as it wasn't working (i believe).

-Prevention efforts can ensure that this bug goes away, but funding hasn't been so secure lately and some of the model programs domestically and internationally have had to cut back lots. It sucks to see some of the places where I've worked struggle with funding even though they've been doing everything exactly as they're supposed to.

Seven of Nine said:
According to Luc Montagnier, AIDS is something that can be cured with a good diet :(:scared::scared::wow::uhno::wtf:


Unfortunately, the Nobel Prize Disease has struck again.
Click to expand...

When did he make that comment exactly?
Citation?

Back in the old days when people were arguing that it wasn't a viral thing or if it was an HTLV vs a novel virus (gallo vs montagnier), I remember reading about someone who was so vehemently against the fact that it was HIV (at that point unnamed) that he injected himself with some during a speech because he didn't think the etiology was correct. I don't remember reading anything further regarding what happened to him.
 
ridethecliche said:
Few things:

-Bone marrow transplants might be more dangerous than having HIV. HIV can be controlled so as to make it a chronic condition now. It still sucks, but it's no longer a death sentence and never has to go to AIDS.

-If you're talking about Elite Controllers, i.e. those that get HIV but will never get AIDS even without drugs, then you can induce their mutation in people, but why would you? Would you want to make the entire worlds population susceptible to the next virus that runs through? You're just changing the cell binding protein.

-The saddest thing about HIV is that mother to child transmission is pretty much completely preventable, but so many people aren't tested and don't get the drugs that would effectively stop transmission.

-The other neat research going on is in PrEP (pre exposure prophylaxis). This has been shown to be effective in gay men, but the heterosexual trials were stopped early as it wasn't working (i believe).

-Prevention efforts can ensure that this bug goes away, but funding hasn't been so secure lately and some of the model programs domestically and internationally have had to cut back lots. It sucks to see some of the places where I've worked struggle with funding even though they've been doing everything exactly as they're supposed to.



When did he make that comment exactly?
Citation?

Back in the old days when people were arguing that it wasn't a viral thing or if it was an HTLV vs a novel virus (gallo vs montagnier), I remember reading about someone who was so vehemently against the fact that it was HIV (at that point unnamed) that he injected himself with some during a speech because he didn't think the etiology was correct. I don't remember reading anything further regarding what happened to him.
Click to expand...

There was actually a study done on PrEP (kind of) by HPTN (HIV Prevention Trials Network) that was ended ahead of schedule because of overwhelmingly positive results. HPTN052 showed that in partners with discordant HIV serology, transmission was reduced by 96% vs. the control group. While this isn't the classic PrEP that you may be talking about, it is still a boon to preventative treatments, and it even avoids giving treatment to an HIV-negative person. It also hammers home the point that ART is becoming increasingly effective in not only controlling the infection, but also helping prevent transmission.

As for changing CCR5...I think people are talking about it more as a treatment rather than a "vaccine." It would be pretty dumb to so drastically limit the number of genotypes in a population.
 
HINKLO said:
There was actually a study done on PrEP (kind of) by HPTN (HIV Prevention Trials Network) that was ended ahead of schedule because of overwhelmingly positive results. HPTN052 showed that in partners with discordant HIV serology, transmission was reduced by 96% vs. the control group. While this isn't the classic PrEP that you may be talking about, it is still a boon to preventative treatments, and it even avoids giving treatment to an HIV-negative person. It also hammers home the point that ART is becoming increasingly effective in not only controlling the infection, but also helping prevent transmission.

As for changing CCR5...I think people are talking about it more as a treatment rather than a "vaccine." It would be pretty dumb to so drastically limit the number of genotypes in a population.
Click to expand...

It is obvious that the CCR5 gene therapy would be a treatment and not a vaccine.

PrEP is interesting as a strategy to slow down the spread of HIV but it still isn't the kind of solution I think clinicians are looking for. I think it's a sloppy strategy because there are side effects, but it works. We should definitely use it, but concentrate our efforts on a more streamlined molecular therapy approach. I like the virus vs virus idea.
 
chronicidal said:
Definitely.

CCR5d32 increases risk of symptomatic West Nile virus infection.
http://www.ncbi.nlm.nih.gov/pubmed/16418398
Click to expand...

I actually did a case study on this paper and another. It was quite a thorough study actually. To make a direct counterpoint though, as far as science to my knowledge knows, WNV cannot be transmitted human to human, so it will probably just remain isolated cases. Then the counterpoint to that is "who knows what other diseases are aided by homozygous CCR5 delta 32?"

What do you think some criteria should be for determining if ART is appropriate vs. introducing CCR5 delta 32 (assuming it is a feasible treatment)?
 
Gotta be honest, I hadn't heard of the CCR5 HIV resistance/immunity until this thread. Absolutely fascinating. Thanks for the info, guys.
 
Geekchick921 said:
Gotta be honest, I hadn't heard of the CCR5 HIV resistance/immunity until this thread. Absolutely fascinating. Thanks for the info, guys.
Click to expand...

Look up the connection between the ccr5 delta32 mutation and the plague.

Other diseases such as cystic fibrosis are also theorized to have "survived" through the years despite decreased fitness due to increased resistance to other disease...i cant remember which disease CF helped prevent (did a case conference on this like 6 months ago).

Also just to put into perspective the advances we have made against HIV. We have these patient perspectives here at PCOM (which are usually pointless)...but we had one of HIV that was AWESOME.

The two presenters were HIV patients who were both infected in the late 70s and are STILL alive and doing really well...both undetectable viral loads. THAT totally blew my mind.

Yeah HIV sucks and its obviously a huge issue in other countries and in minority populations in the US....but I think there are far scarier diseases out there!
 
willen101383 said:
Look up the connection between the ccr5 delta32 mutation and the plague.
Click to expand...

I did and was totally nerding out over it. I read they think it might actually be a smallpox resistance instead of plague, though. Either way... awesome.
 
Geekchick921 said:
Gotta be honest, I hadn't heard of the CCR5 HIV resistance/immunity until this thread. Absolutely fascinating. Thanks for the info, guys.
Click to expand...

you'll see it in med school when you discuss HIV for sure - so it's great that you have heard of it now. there are also some other protective mutations in the promoter for CCR5 (which makes sense of course).

one crappy thing about this is that some HIV strains use CXCR4 instead of CCR5. seems to really only play a role when you see a CCR5-/- patient with HIV.
 
Geekchick921 said:
I did and was totally nerding out over it. I read they think it might actually be a smallpox resistance instead of plague, though. Either way... awesome.
Click to expand...

Yeah u got it. I think they originally thought it was plaque...and then decided it was smallpox...either way its great stuff and totally interesting!
 
I wish we heard more about these sort of things on the news than...Oh great, the troops in middle east....Yep, still there and still getting killed everyday.
 
MeowMeowCAT said:
I wish we heard more about these sort of things on the news than...Oh great, the troops in middle east....Yep, still there and still getting killed everyday.
Click to expand...

Totally agree with you. Go read the CNN comments on your average political article. Most of those *****s wouldnt even be capable of understanding the science. I love reading the comments more than the articles on CNN haha. Such idiocy out there.
 
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