New antibody attacks 99% of HIV strains (opens in new tab)

I don't think this is relevant in that case. I am not an epidemiologist but I worked with people who were studying HIV. My understanding is that while the HIV mutates fast, it does not create new strains during the treatments.

A given strain can have some variability but will share general traits.

HIV strains are named and numbered: https://en.wikipedia.org/wiki/Subtypes_of_HIV

An efficient treatment against a specific strain would save millions of lives. An efficient treatment against the 99% of them that are the most prevalent would basically solve the epidemics.

The problem is that people often end up with more than one strain. This is why doctors tell HIV+ people to continue protect themselves and were worried about the appearance of "free-sex parties" for HIV+ individuals. Most people do not differentiate between strains but if you got HIV from a partner, you may have had only a part of their strains, you should not have unprotected sex if you want to maximize your chances.

Reminds me of a lesson about misleading statistics I tell my nephews. We've all see the hand sanitizers that advertize killing 99.99% of germs, but what does that actually mean? 99.99% equates to 1/10,000 survivors and assuming for each generation the population doubles means it takes just 14 generations for the original colony to be back at full strength again. For extra creepy effect, e coli can reproduce in optimal conditions as fast as every 20 minutes which buys you only a couple hours of hygiene[0].

Given this drug kills 99/100 HIV virus units, then this really only helps you for log2(100) or ~7 generations

The math is pretty easy, but the results are something that always surprise me: it turns out humans are pretty bad at estimating exponential growth.

0: real life conditions are probably slower than this, I concede.

I'm not familiar with any details about this vaccine or other therapies, but from what I understand is when you have a partial solution or near total solution like this, you combined it with another therapy so you have two methods of action to dealt a "kill shot" to the target organism or virus. This combined therapy strategy is used in killing Borrelia type infections. Basically they combined two different antibiotics at the same time. Alone they are effective at relapse rate of say only 5% after 14 weeks, combined they can get near 1% or lower. Also when an organism evolves, its genetics can drift causing mutations that are disadvantageous. There a chance the mutation could make it more vulnerable to something just as well as immune to something else, and also there has to be consideration that there is a scenario where that can happen at the same time.

HIV was/is an early hint at the computational complexity we face in understanding biology.

Not that we should consider in insurmountable nor ungrasp-able. But that we -- or parts of our society and professional institutions -- should lose some of our arrogance.

On the upside, that complexity also harbors enormous opportunity. Just, don't be simplistic about it an let your ignorance take you into disaster.

While your argument has some validity, the statement said "New antibody attacks 99% of HIV strains" not "New antibody attacks 99% of HI Viri (of a given strain)". The mutation would have to occur faster than the virus dies off.

I'm sure that it is much more complicated than this, but I wonder how long the virus can remain immune to all previous '99%' cures? Maybe eventually we could come up with enough of these and then administer them all at once.

This is the fundamental problem with treatment of rapidly evolving diseases. The hope is that if you get a "good enough" treatment and get it out to the population rapidly enough, the disease won't have a chance to evolve and spread further. Herd immunity will bring it under control.

I think the problem with a widespread, highly studied virus like HIV is that a "good enough" treatment isn't "good enough." Any treatment will be deployed in a limited manner to test the efficacy, which will in turn give it a chance to develop a resistance and spread.

That having been said, if the treatment CAN treat 99% of current infections, it will be a boon for at least a couple generations of gay and minority communities in the developed world.

Antibody manufacture is not cheap. The antibodies are made by fusing the b-memory cells with mouse cancer, then putting the result in a bioreactor and filtering out the desired product, which must then be refrigerated. Drugs that use this technique commonly end in -MAB (for monoclonal antibody).

Not that it helps Africa but in the US for a drug like Truvada (PrEP) it costs ~$1500/mo on insurance but they offer a copay card that covers $3600/yr which is enough to hit my deductible at least so after 2 months I only pay $30/mo but in practice I don't pay a dime because the copay card covers it all.

If this is produced by Pfizer or some other company he is invested in, sure. Otherwise he will fall back to talking bs all day long like he does with Malaria.

For those downvoting: His foundation made sure the WHO subcontracts all studies to companies he has a stake in. He isn't a saint, he is a capitalist.

I cannot personally do so, but I know who can and almost certainly will. The 'This Week In Virology' podcast. It's run by the head of the Columbia University virology department and a few other respected researchers in the field and is an absolutely phenomenal resource whenever there is news about virology. It doesn't look like they've covered this yet (too new) but I expect it to feature large in their next episode. If you're interested in a real technical dive into the topic, that is the place to go.

http://www.microbe.tv/twiv/

(Related personal anecdote and why I recommend them so highly: I'd been listening to them for awhile, then a research paper came out showing a possible link between Chronic Fatigue Syndrome and XMRV in mice. People online had taken the paper and went crazy with it and some people were finding sources for murine (mouse) cancer drugs and dosing themselves with it in hopes of curing their CFS. They went through the paper and recognized the researcher and lab who wrote it. And noted that the lab had previously published XMRV research. XMRV is apparently remarkably difficult to eliminate contamination from. Basically if a lab has ever worked with it, you have to burn down the lab and build anew if you want to be sure it isn't around. So they advocated skepticism and said wait for independent verification before getting too worked up. A couple months later, the original paper was retracted as the researchers announced no other lab could reproduce their findings and it was down to XMRV contamination of their samples. That is the kind of thing you only get when you're listening to bona fide experts in their field and it blew my mind.

The study looked at SHIV, so they did it in monkeys. A little different. I haven't looked at most of the study but I would imagine that as an antibody it would have some sort of specificity.

In the 1980s, getting HIV was a quick death sentence.

In the 2010s, getting HIV means that you are likely to live until... Your 70s. (Assuming you have access to medication.)

The problem is that you need to take expensive medication for the rest of your life. And that you can infect other people.

> People won't become totally sexually irresponsible after the preventive shot, because there are many other hard to cure STDs now, especially as antibiotics are not as potent as they use to be, so i think there is no threat of 1960s style of unprotected sex wave.

The way you've phrased this, it sounds like you are casting "other hard to cure STDs" as a protective measure against the "threat of 1960s style of unprotected sex wave."

Isn't sexual freedom a goal?

I think the 1960's unprotected sex wave was more a symptom of ignorance of STDs. People used to see condoms as primarily for birth control, and not really a sanitary measure. Remember, the birth control pill came out in the 1960s!

Even then, knowledge of condoms wasn't widespread like it is now. My grandmother was super-pissed-off when my grandfather told her about them after she was pregnant for 18 months straight! She made it a point to tell me that I had to tell my future wife about birth control! (What made it funnier was that, at the time, if you didn't know what a condom was you were living under a very large rock!)

If there is no significant chance of untreatable disease, it is not 'irresponsible' to have a very active sex life. The irresponsibility stems purely from the danger. Without it, it becomes a moral issue and is quite different from 'irresponsible'. And yes, there are people who actively oppose any development of an HIV vaccine or cure due to their moral fear that people will start having more sex. The chaplain of the CDC announced in the 1990s that he would do anything in his power to prevent any research into an HIV vaccine, for example.

The most likely significant health threat as far as STDs go in the future are anti-biotic resistant gonorrhea. There were a couple of those spreading in Asia a couple years ago that were positively nightmarish.

I disagree. I (annedoctally) heard several times stories about how today's youth (~20yo) doing more unprotected sex than my generation (~35yo) only because HIV "does not kill anymore".

If AIDS is actually curable, I would bet that all other STD would explode in the short term

99% of strains isn’t necessarily 99% of all infections, and won’t be anything close to it soon after this gets used in humans.

If one assumes that the different strains also compete against each other the total number of infections may not go down much, and if it does, that may only be temporarily.

Not really, no. Modern antiretrovirals are exceptionally effective, and for those with access[1] HIV/AIDS has become a chronic illness, with nearly-similar lifespans (due mostly to chronic inflammation).

We still haven't come close to "eradicating" or curing HIV/AIDS; the issue lies in the virus' insidious biology. HIV is a retrovirus, meaning it incorporates into the target cell's genome, specifically CD4+ T-cells. An obvious barrier to "only" 1% of virions is that an infected person produces billions of virus particles every single day[2]. A less obvious barrier is the "latent" reservoir of the virus in cells.

Essentially, not all cells with an incorporated HIV genome are producing virus, and thus these proviruses can evade detection. A 2013 paper in cell[3] provides what I think is the most devastating example of this. Basically, an idea that has gained more traction lately has been to activate these T-cells, thus alerting the immune system and hopefully clearing the virus. It turns out that not all cells are activated, and the size of this reservoir is ~60X larger than previously thought.

When it comes to something like cancer, we often define "cure" or "beating it" differently — look no further than Randall Munroe's heartbreaking visualization, Lanes.[4] We need to do something similar for HIV. We can't get rid of the virus, but we're already pretty good at making life not so bad if you have it. Access and affordability are larger barriers to preventing mortality/morbidity.

There's also a quiet undercurrent that a standard vaccine for HIV is biologically impossible, but that's for another day.

tl;dr HIV sucks but we're okay at managing it. 99% sounds good but it's probably not enough.

1: Read: moderately well-off people with health insurance in wealthy, industrialized nations.

2: DOI: 10.1038/nrg1246 The oft-cited rule of the thumb is that every base of the viral genome is mutated every day.

3: DOI: 10.1016/j.cell.2013.09.020 This one is absolutely worth reading.

4: https://xkcd.com/931

Even at 100% eradication would be very difficult. As far as I am aware, smallpox is the only disease we have successfully eradicated. If you count non-human diseases, this number climbs to 2 with rinderpest.

This is assuming that we can get the vaccine to everyone. In first world countries with developed and trusted this is mostly possible, but would still be a massive undertaking.

> so i think there is no threat of 1960s style of unprotected sex wave

That's your takeaway from this interesting news? I don't understand how you jumped from this article to immediately drawing some opinions about sexual responsibility and behavior. The article has nothing to do with sex behavior, and HIV is hardly the sole deterrent for reckless sex.

"sexual responsibility" is quite an odd concept, it should be defined more precisely.

> no threat of 1960s style of unprotected sex wave.

Are you implying that unprotected sex is bad in itself?

Edit: It was an honest question.

thank god.

From a medical standpoint, HSV and HPV are largely cosmetic and very low priority. HPV is/was perhaps a slightly higher priority because it can rarely lead to certain cancers, but the vaccine Gardasil aims at those types of HPV.

Given the sheer diversity of HPV strains, I'm doubtful that we'll ever eradicate it, as a number of them are either genuinely or largely benign, and an out and out viral eradication campaign is a long term, sustained and global effort that is invariably very expensive.

Actually getting the vaccines that cover the high risk strains into the developing world is a much more obtainable goal, and even that is extremely challenging for a number of reasons.

Don't they have the HPV vaccine Guardasil?

Why would you link to that discussion? Here is what I see as the "top" comments:

  -what about that 1%? I'd fear if it became the new super HIV
  --Can you not appreciate the 99%?
  ---He's a 1%er for sure...
  ----Let's git im!
  -----ANGRY AT OP? WANT TO JOIN THE MOB? I'VE GOT YOU COVERED! COME ON DOWN TO /r/pitchforkemporium...
  ------Here you go Comrade
  -------!redditsilver
  --------Here's your Reddit Silver, ZarathustraV!
  ---------Good bot

Seems like I’m getting downvoted, so to be clear I just wanted to add a link to a relevant discussion. I really should’ve linked to the r/science one.