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.
I mean yeah, if a patient is on HAART with an hiv RNA <50, the risk of transmission to a partner is greatly minimized. Honestly, if everyone that was positive was on a successful regimen, the transmission would be drastically different.
I'm not going to offer citations for this because no doc would recommend it, but if you're a serodiscordant couple trying to conceive and the HIV+ partner has an undetectable viral load, then the chance of transmission to the partner (and the child) is close to nil.
I remember watching a PBS documentary on this mutation back in 2004ish.
Maraviroc capitalizes on this, however it's not a permanent solution and has effectiveness similiar to traditional HAART.
One thing I always wondered is how much active virus does one need in their body to cause HIV? I mean I assume with trillions upon trillions of copies of this virus, most people will have at least 1 copy of the virus in their body. I mean let's say you have just 1 copy of the virus, would that be sufficient to cause the disease over a short enough time period to be felt in your life?
Or would it be excreted or "stastically" washed out in that it would take too long for it to reproduce enough to be noticed by the host.
I think you meant to say AIDS when you said HIV first. As causing HIV makes little sense. If you meant HIV disease, then I mean if you're positive, you're positive. AIDS is usually when the symptoms start, unless you're talking about seroconversion which is like the flu.
In any event, it's an exponential growth. I'd gander yes, but there are too many variables to determine what exactly is going on. It's usually 5-15 years from infection that one progresses to AIDS (defined either by OI's or CD4<200). So if you double that even, 10-30 years is still within my lifetime.
Now if you want to talk about something really crazy look up IRIS. That's something that's a little more complicated to manage. The south african physicians I've worked with deal with tons of this stuff.
