What happens if we manage to kill 91% of the HIV strains? Won't the remaining 9% of the strains continue to spread and mutate? Then we're back to square one.
Likewise, 91% of the strains is not necessarily the same as 91% of the people currently living with HIV. Can anyone provide details on what, exactly, this finding does? Do we need to kill 100% of the HIV strains to have a cure? Is there one strain that is the "dangerous" one, and it isn't covered in the 91% number? Will the virus simply mutate new strains?
I'd assume it means 91% of strains of HIV. It means that the odds that someone has a vulnerable strain is greatly increased and thus you can heal more people.
HIV has a few limits, firstly (I think) it only infects one type of cell (CD4 immune cells - white blood cells), secondly, it doesn't spread as easy as influenza, you need to exchange some bodily fluids with someone, preferably with an abundant supply of CD4 cells to infect. Since it generally requires sex to get HIV, if you knock out 91% of strains the other strains wont rush in to fill the vacuum.
The resistant strains already present will almost certainly increases as a proportion of the HIV population, its just natural selection. Use of condoms can prevent people from getting the resistant strains. Interestingly, male circumcision is also an excellent way to reduce chances of HIV infection because there will be less CD4 cells in your penis.
There's rarely an antibody that kills every possible strain of a disease, illustrated by the fact that there is not an antibody that kills every disease. 91% of HIV strains means we are 91% of the way to complete eradication.
Plus, one of the big problems thus far have been we had NO IDEA how to attack the HIV bodies. Perhaps developing an understanding of this antibody will allow us to gain new understanding, and perhaps in good 'ol engineering tradition we will be able to change this, that, recompile, and cover a few more %. I know it's not that easy, but if you've ever developed code or hardware, having pre-existing, working models makes everything miles and miles easier.
91% of HIV strains means we are 91% of the way to complete eradication.
That is inaccurate. Current antiviral agents remove most (as in over 90%) of the HIV viral particles from the blood of a patient. But then after weeks or months the viral load in blood is just as high. And any given patient has numerous strains within. Furthermore, most viral particles are not active: the virus saturates the immune system with defective particles (in a way it screens itself under noise). What's worse, HIV has long-term repositories like nervous system cells, from which particles are emitted at low rate. Killing your brain cells just to get rid of HIV defeats the purpose.
What this novel antibody will do is to remove 91% of the strains, meaning the remaining 9% will flourish enormously . RNA viruses mutate very fast and broadly (always being one step before crash-error).
What a good antibody can do is cut short the epidemics side of HIV: if a patient's HIV load is so low that it can't effectively and consistently pass on its infection to another person, the infection dies with the patient. This leads to a negative feedback loop that stops the epidemic. It's the same concept as vaccines: ensure that a sufficiently large proportion of the population is immune, so infections cannot spread when they inevitably appear in isolated individuals.
Yeah, that's why the usual solution is to cobble together a bunch of different 90% solutions until you have something pretty close to a 100% solution. Scientists are going through something similar with fighting wheat rust (which you've probably never heard of, but it'll be an important problem if it gets out of control).
The problem with HIV is that every obvious way of attacking it seems to have some kind of drawback that's less than obvious. You can sit around and think up all kinds of hypothetical scenarios for attacking it and find that people have already tried that. And failed.
I guess should have known that the people around here would know what wheat rust is. But yeah, that stuff is pretty nasty, as far as its ability to kill wheat goes.
At the very least, it could buy a second chance for a lot of people, even if it's not all of them. I'm sure there's plenty of people out there who are not career druggies or sluts who had one stupid or unlucky night that is going to ruin the rest of their lives, and could use a second chance.
EDIT: sorry, I worded this terribly. What I meant was there are many people who would not catch HIV again, and thus would benefit from a cure to only 91% of HIV. The people who will continue being reckless and catch it again will, of course, not benefit from an antibody protecting them from only 91% of HIV, and that was what I was talking about when I referenced druggies. I'd be more than happy to give hardcore druggies a cure.
The whole point was not that some people deserve it and some don't, but that some will gain huge benefits even if it's only 91%, and that is why even though it's not 100% coverage it's still a plus. (of course, not everyone will, because some people will go and catch the other 9% right away, so for them it's not really a benefit, but SOME WILL BENEFIT)
EDIT2: to those of you still downvoting, are you trying to say you think every single person on the planet with AIDS would not catch it again if they were cured, but still vulnerable to some strains? That seems kind of unlikely.
I remember reading in "The Tipping Point" by Malcolm Gladwell how STDs like HIV can be effectively stopped before they become epidemics. If this antibody can be administered and eliminate a large chunk of people with weaker strains of HIV, then assuming the stronger strains of HIV are in the same geographic area, a strong campaign of eliminating HIV spreading behavior in those areas could really reduce the spread of the disease. But like another poster said we don't know which strains are most prevalent, so it could be that a stronger strain is more widespread.
"a strong campaign of eliminating HIV spreading behavior in those areas could really reduce the spread of the disease."
That's a LOT easier said than done. There's a widely held belief in parts of the world (such as Africa) that having sex with a virgin cleanses one of AIDS. Because of this, child-rape is extremely prevalent in that part of the world. I suppose you could make the case that education is the easier part of solving the AIDS/HIV puzzle, but it's a very large behavioral problem that can not be solved using a scientific approach.
you have a good point but we have no idea which areas are affected by the antibody. If Africa has a majority of strains that are cured, then I'm sure they could stem the spread of the disease in more developed areas. I don't think that belief is widespread outside of africa, or at least I wasn't aware of it.
It's really a testament to nature and Darwin's theories that after all the time, effort and money we've been spending on AIDS research, the most successful antibody so far was not created by man, but by his DNA.
I Am Not An Immunologist, but antibodies are usually produced by plasma cells, after their predecessor B cells are triggered with the appropriate antigens, right? I'm pretty sure that mechanism and its memory is acquired, not innate. In other words, it's not coded for by DNA, and you can't inherit that immunity from the father. Some maternal antibodies are heritable, but I think that's through shared blood.
For 'Not An Immunologist' you seem to have a pretty good handle on this stuff. You're mostly right about the heritability stuff, but it's a bit more subtle than that.
Antibodies are built from heavy and light chains, which are in turn produced by a combinatorial recombination process: subunits get spliced together. While paternal B cells aren't going anywhere with regards to heritability, the heavy/light chain subunit repertoire is heritable! If Donor 45 is a mutant for one of those subunits, then the effect could very well be heritable.
Are any antibodies entirely genetically determined--"off the rack", so to speak? One would think that having an innate immune response to extraordinarily dangerous yet infrequently-mutating pathogens (polio, for example) would be worthwhile.
Haha, maybe I should get go get an immunology text. I think I'm pushing the limits of Wikipedia.
The process is amazing. It's a giant highly optimized molecular recognition library. Random diversity in antibody binding motifs is generated by guided mutation of the DNA coding for the proteins in the antibody. This wide repertoire is then screened for antibodies that react to 'self' molecular patterns in the body, and the B cells producing those self-reacting antibodies are deleted. One B cell produces only one kind of antibody.
There is also evidence that this antibody repertoire is further primed and refined by constant interaction with the incredible molecular diversity produced from the bacteria that live on our mucosa (that is, barrier interfaces with the environment like the lining of the gut and lungs and the skin).
The immune system naturally tweaks antibodies to make them more efficient at binding (Affinity maturation it's called). If you are trying to make a vaccine, you are better off starting off with an antibody which has already had all the hard work done on it.
It should be pointed out that the donor they used is actually infected with HIV, the antibody didn't protect him because prior to infection it wasn't affinity matured or present in high enough concentration.
If there was a heirarchy of medical treatments, vaccines would surely be at the top. A jab when you are too young to remember and suddenly debilitating fatal diseases that have plagued humans for thousands of years are no longer a problem. The immune system is unique in that you can give information to it, you can communicate with it. It's an information technology, actually. I think this is why vaccines are so fantastic, it is a treatment that collaborates with the body. Pretty much all other medical therapies involved taking a broken system and breaking it even more to achieve some kind of withered stability which is inevitability temporary and has consequences for the organism as a whole (eg giving steroids for rheumatoid arthritis, chemotherapy for cancer).
The seasonal flu vaccine is a global immune system in action. It's a molecular rss feed, an app update, a glycoprotein tweet whatever analogy you care to use, perhaps one day an individual's immune system will be part of a greater whole linked via information tech. The immune cloud it might be called.
And millions will still die because of war and poor sanitation and exploitation.
It would be pretty sad if someone used the immune cloud to distribute a virus. I wouldn't want to live in a world where I had to trust AVG anti-virus with my health.
It would be pretty sad if someone used the immune cloud to distribute a virus
Yes, that would be horrible. Imagine a deadly virus which specifically infects immune cells to spread. We could call it something like Human Immunodeficiency Virus.
You are partially on the right track. There is an innate response to pathogens exhibiting particular molecular profiles. But this innate recognition is not by antibodies, which are part of the adaptive response.
To my knowledge, there is not a repertoire of antibodies that are automatically produced, per se.
I think we're making good progress when you look at how long we've been at it vs. how long nature has. I mean we at least knew where to look for the solution!
This antibody, however it was created, will now be a good starting point for tweaking and improvement. Hopefully, it can be made to be effective against 100% (or as close as possible) of the HIV variants.
> On the other hand, the antibody would never have been noticed if we hadn't been spending all this money on research.
Indeed. But, even though he is a homosexual man, the gene would likely be passed along eventually, and run its course through the human race (if we believe Darwin). We just don't want to wait that long.
note: it would be passed one of a few ways:
1) his ancestors also had the gene, and he's not the only one to get it. He has heterosexual relatives who will pass it along, and they simply weren't found for one reason or another.
2) he wavers in his homosexuality, and passes his gene along to a few women OR he is bisexual
3) he donates sperm
4) it happens again in a heterosexual person. This gene arose in something like 30-40 years (I'm not really sure just how many) since the beginning of AIDS, which is an evolutionary blink. I think it's not unreasonable to figure it would arise again, and that it wouldn't take a bajillion years
I don't think the gene arose in 40 years. Obviously it didn't, since the man is more than 40 years old. Instead, I think it's a gene that arose via happenstance and is suddenly much more useful.
Still, the fact that it was already floating around I feel proves my point even more. If the disease ravaged us for hundreds of centuries before this cropped up, THEN it'd be pretty reasonable to say it's highly unlikely to develop again anytime soon.
I love how that got down voted and the general amount of HIV fud in this thread - I actually do HIV research, I would know.
Most HIV people get infected by one strain, but it mutates so rapidly that in a single individual, multiple strains co exist at different levels (a major one and many, many lower levels ones).
I doubt that infection with one strain of HIV is preventing infection with another strain, except to the extent that some of the people engaging in the most risky behavior are getting "taken out of the system" by AIDS. Something like this could lead to exponential decline among certain subnetworks of society.
So if there's eventually an HIV vaccine that's 91% effective should everyone take it just in case? Even if you never expect to contract HIV this seems like a bit of a Pascal's Wager situation. Why risk it when there's a vaccine available?
