Lots of people have been emailing me about this article, currently rotating through the usual science news outlets:
Look, guys, I am obnoxiously optimistic about the future of HIV/AIDS. I have no doubts about our ability to one day make HIV/AIDS a distant nightmare, like polio or the plague.
And I also have no qualms with the paper these articles are based on, Establishment of HIV-1 resistance in CD4(+) T cells by genome editing using zinc-finger nucleases. Its neat! Yay!
But let me dump a big bucket of ice cold realism on the press release that spawned those ‘science journalism’ articles: This research is completely impractical in The Real World, and it sure as hell doesnt “Put Personalized HIV Therapy Within Reach”. Giving the general public that impression is deceptive and mean.
Again, I want to make it clear that I dont see anything ‘wrong’ with this paper. Its made up of good science and good ideas. My problem is the way its been ‘framed’ (as usual), so lets just look at the paper and its implications without spin.
You all might have heard of individuals who are naturally resistant to HIV-1 infection because they dont have a functional CCR5 gene (CCR5-Delta32). These people have no obvious deformities or abnormalities, so evidently you can live a pretty normal without CCR5.
However, most of us do have a functional CCR5. So we are totally screwed, right? Maybe not! This paper outlines some experiments done in mice born without an adaptive immune system who were injected with human T-cells that had been treated with a gene-therapy vector to screw up the T-cells CCR5 genes. The end effect is that the T-cells in these mice dont have functional CCR5s. When these mice were challenged with HIV, their modified human T-cells survived longer, and their viral loads were lower!
So, theoretically, one day researchers could take some T-cells from you, modify them a bit with gene therapy, inject them back into you, and then you would be like a delta-32! No CCR5, harder to get HIV! Or, if you were already infected with HIV, you might be able to hang on to your T-cells longer, thus delay the onset of AIDS.
WHOO!! Personalized HIV Therapy Within Reach!
… Not exactly.
Just to point out the obvious, this experiment has only been done in mice. Cell lines < animal models < non-human primate models < human therapy. A mouse system (especially when mice arent susceptible to HIV-1 infection without some tricks, like they used in this paper) is a far cry from a human clinical trial. These guys still have a loooong way to go to reach a workable therapy.
And, there is a major problem with 'just getting rid of CCR5'... CXCR4. Because HIV-1 can evolve to use CXCR4 instead of CCR5, 'just getting rid of CCR5' would be like closing your front door to keep a zombie outside... while leaving the back door wide open. It might take the zombie a minute, but hes gonna figure it out and feast on your brains.
But lets ignore all that. Lets pretend that human clinical trials go perfectly.
Lets pretend that for some reason, HIV-1 doesnt evolve around CCR5 to CXCR4.
How the hell is this ‘therapy’ going to help the people who need help the most?
Theyre going to take this treatment to rural Africa?
Ya they dont have reliable electricity or running water, but gene therapy, thats doable.
“Personalized HIV Therapy Within Reach” of people who could afford this kind of therapy. People in the US/Europe who can afford anti-retrovirals in the first place.
The people who need this therapy couldnt get it, and the people who could get it, dont need it.
Im just so annoyed and so frustrated.
Just let science stand on its own. Appreciate a good idea and a well designed experiment. But this kind of patronizing PR is shameful.