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Diagnosed with HIV in 1995 and in 2006 Leukemia. Bone marrow transplant to cure his leukemia. This involved a stem cell transplant from a donor who was naturally immune to HIV and has been able to live fully healthy without ARTs ever since There can be strains of HIV that are drug resistant
The majority of HIV cannot enter a human cell without a functional CCR5 gene
Quote by international AIDS society president
Saskia take the first 3? Yes! PrEP: Pre-exposure prophylaxis
Current Research in HIV/AIDS
Modern Drug Treatments for
HIV: Potential Cures
Saskia Leonard and AnnaTong
Why look for a cure?
Timothy Ray Brown, also known as the "Berlin patient," was the first person to be cured
of HIV infection, more than a decade ago.
- HIV is not a death sentence anymore with daily intake of medication
- But only 21 million of 37 million people have access to drug therapy
- Lower-income countries have lower access to consistent/wide spread treatment
- Drug resistant virus
- Now researchers are reporting a second patient has lived 18 months after
stopping HIV treatment without sign of the virus following a stem-cell
- Referred to as “London Patient”
- Was suffering from Hodgkins Lymphoma and was infected with HIV
- Received bone marrow cells as part of his cancer treatment in 2016 from a
donor who had a malfunctioning CCR5 gene, which creates a protein crucial
for HIV to invade white blood cells
- Key is to shut down the CCR5 gene
Why is this exciting?
- Big news for the research community looking at how
gene therapy can disable the CCR5 gene by using
other technologies including the gene editing technology CRISPR
- Proof that HIV is curable
- “The hope is that this will eventually lead to a safe, cost-effective and easy
strategy to achieve these results using gene technology or antibody
- Informs broader community- in the news!
Why is it problematic?
- Not readily available to do a stem-cell transplant
- Can have severe side effects
- Stem cell transplants are risky
- Donors must be a genetic match to recipients and very few
people naturally carry two copies of the disabled CCR5 gene
Genome Editing - A Controversial Case
● Chinese scientist who made the world’s first genome edited twin babies: He Jianuki
○ Impregnated a woman with babies who lacked the gene utilized by HIV to infect cells
○ The editing was successful and only the target gene was edited
● Used CRISPR-Cas9 genome-editing tool to disable CCR5 - protein used by HIV to enter T-cells
● Father HIV-positive
Ethical Implications of Gene Editing
● There are other safe and effective ways to use genetic editing for HIV prevention
○ No unmet medical need that gene editing fulfills
● “Directly jumping into human experiments can only be described as crazy”
● Marginalizes already marginalized groups - very expensive
● Where to draw the line in terms of gene editing
● Incredibly risky- may target other genes inadvertently and may affect other normal functioning
● Some strains of HIV do not even use this protein to enter the cells, but use another called
Other advancements in treatment
- Conference on Retroviruses and Opportunistic Infections making progress on treatment especially in Africa
- Monthly injection of HIV drugs suppress the virus the same amount as daily pills
- Good because many people forget to take their pills daily.
- Doctors working in impoverished countries are eager for injections or implants that will release small daily
doses of antiretroviral drugs because the devices can be used in secrecy.
- Providing injections may be harder than handing out pills, but the option may attract patients with H.I.V. who
would otherwise stay away because of
- Fear and stigma
- Contraceptive injections are favorable and more effective because many women have to hide birth
control from their partners who might get angry that they don’t want more kids
- Gay or bisexual men may want to be discreet, because often hiding from spouses or families that they
have sex with men
- Truveda , PrEP pill, taken every day are almost 100% protected against getting HIV from unprotected sex or
- $20,000/year and hard to get it to uninsured in the US
- Discovy is an alternative to Truveda that is cheaper but more likely to raise cholesterol, which is problematic