December 29, 2010
If we analyze the Google usage of any newly diagnosed HIV-positive person, chances are 90 percent of his search history will reflect the phrase "HIV cure." The idea of waking up one day and finding out that there is a cure to your HIV that could replace your daily pills with a once-and-forever treatment is a dream to every Poz person in the world.
When we discuss the issue of HIV cure, we must keep in mind that it is not only a discussion of seeking better options to replace the current effective treatment system. A cure is not related only to people living in the northern industrial sphere who enjoy the privilege of accessing effective treatment and merely suffer from the side effects of the long-term dependency on them. A cure is in fact the ultimate solution to the problem of AIDS, which is crippling many developing countries in Africa, Asia and even in South America and Eastern Europe -- a situation that is still devastating their growth and human development plans; a cure must be conceptualized within this important frame.
However, the fact remains that until recently, most of those who work in the medical field were heavily influenced by the weight of what seemed to be a legendary ability of this virus to overcome a "cure." Years of disappointment diverted the international community and the donors' attention to focus more on providing and improving current treatment than on wasting energy and resources on what many saw at that time a Sci-Fi goal of HIV cure.
As some of you know, HIV entry into CD4 cells requires interaction with a receptor in the cell. This receptor functions as the arm that is ready to shake hands with the invader; this arm is generally either CCR5 or CXCR4. If these arms are missing, no one will be welcoming HIV to his new home. In the past attempts to find a cure, the focus was on the virus itself, and scientists overlooked the fact that the body might be much friendlier to our attempts than the virus, a theory proven right in Berlin.
An American HIV-positive patient, after stopping treatment, witnessed no replicating of HIV. This was a proof that this patient was "functionally" cured, and the legend of the incurable disease has become history.
Of course, it was not as simple as this. The patient had to undergo a transplantation to replace his CD4 cells with new cheap ones from IKEA that lacked the betraying arms which act as receptors to the virus (sorry I can't stay serious for more than 10 lines). Seriously, this type of faithful CD4 exists in a small portion of lucky people. Prevalence is in the range of 1 to 3 percent among white Caucasians. The process could be seen as replacing the immune system with a superman immune system -- an operation that is risky and difficult in many ways. It is not simply going to the Doctor and saying that you want an immune system that is resistant to STDs as you are planning to go wild over the weekend.
Now the part that really interests me ... is how the American patient feels now? Waking up from this ordeal to find out that he not only survived leukemia, but also became HIV negative again, what changes occurred in his behavior? How does he view the world from now on? Being Poz is an identity ... and to lose it would have an impact similar to the one you have when you first acquire this identity. It is not a headache that you wake up from and feel happy that it is not punching your head anymore; HIV is a virus that changes your entire interaction with others and with your body. For example, how would any one of us change his sexual behavior if he passed through the same process of being cured and turning HIV negative again? How would a man change knowing that not wrapping it is not fatal anymore? Would he plan a gangbang party over the weekend to celebrate the new situation ... or would he go to church/mosque shouting "I shall never have sex again, Lord be my witness!"
All these questions are still pending answers; but till we get these answers, the case of our American pal who was cured from HIV should send another important message to the folks at home. He was treated and cured in Germany and even became known as the "Berlin patient," without spending a fortune. And he participated in this medical breakthrough simply because he resided there. Those who argued against the universal health care in the U.S. and painted red anyone who argued for it, claiming its evil socialism, it's time for them to get some red color on their cheeks -- blushing with embarrassment that this medical victory is being achieved in a country where health care is universal. Not one German complained that now an American immigrant is abusing the health care system in Germany and getting cured from HIV with the money of German taxpayers.
The lesson to be learned by scientists (I love it when I throw lessons at everyone as if I am the greatest teacher of all! :), humbly, is: Now is the time to think out of the same box we were confined in for the last decades. This is the time to try new approaches. It is time to establish a fact that within the last five years we witnessed more than one good breakthrough related to HIV. Whether in Berlin or in Thailand, they all had revolutionary methods. It seems that the battle is getting closer to victory.
Now, I am not that idiot to say "Mission accomplished" when a battle is still in the beginning ... But I will certainly say: It's time to celebrate a good beginning of our march towards a cure from many directions; it is the beginning of the end of HIV. It's time to get back the trust of the donors that a cure is possible and is indeed the optimal solution to this pandemic which exhausted the world for many years. Thus, funding should pour in once again to support efforts seeking a cure ... and finally, it's time for me to wear my turban again and say: In Islam we are taught, "God never created an illness without creating its treatment." it's the balance of nature and a call to mankind to seek medications, treatment AND A CURE.
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