Ive totally been a Debbie Downer lately.
I dont mean to be, its just that I really friggen hate it when main-stream media trumpets the latest, greatest ‘CURE FOR AIDS OMFG’– and then 10 years later scientists have to explain to the general public why we havent cured AIDS yet.
Why cant reporters just say ‘Hey this is really cool, might contribute to a treatment for HIV/AIDS in the future’?
But again, I dont mean to be a Debbie Downer. I wouldnt be in this field of research if I didnt believe we had a chance of kicking HIV-1s butt some day. We do have a few things going in our favor in this fight. A few little footholds in HIV-1s seemingly unscalable wall that give us hope we will figure out a solution.
1– Using stupid, completely untrue, materialistic, Nazi principles of the theory of evolution, like ‘The Red Queen Hypothesis‘, ‘competitive exclusion principle‘, and ‘Mullers ratchet hypothesis‘, weve figured out that the fitness (the viruses ability to produce progeny in a set environment) of a virus ex vivo is associated with disease progression. The ‘more fit’ a virus is in a culture dish in the lab, the faster that patient is going to progress to AIDS.
What does this tell us? It means that we dont have to worry about every figgen HIV-1 variant in the quasispecies. We dont need to worry about variants that let the patient live for +30 years without drugs. We need to worry about the ‘more fit’ variants that can kill someone very quickly. And we can figure out what makes a ‘more fit’ variant more fit ex vivo. In the lab. This is huge.
2– The relative fitness of an HIV-1 virus (in the absence of anti-retrovirals) is determined by env. If you exchange the env genes between a ‘more fit’ and ‘less fit’ HIV, the fitness pattern follows the env– the ‘less fit’ virus with a ‘more fit’ env becomes the ‘more fit’ virus.
What this means– This is friggen perfect. So we know fitness is associated with disease progression, and we know fitness is associated with env. We make antibodies to env!!! We might not be able to make an HIV-1 vaccine that totally prevents transmission, but maybe we can at least make a vaccine that targets ‘more fit’ envelope proteins! You would still be infected with HIV-1… but ‘more fit’ HIV-1 variants could not evolve, so maybe you could live +30 without drugs.
Giving everyone with HIV-1 delta-32 bone marrow transplants is not realistic to me.
Giving everyone with HIV-1 personalized genetic engineering is not realistic to me.
Figuring out a therapeutic vaccine that improves the quality and quantity of life of HIV-1 infected patients is realistic.