Comment: The docs who cried ‘cure’ – A lookback at HIV in 2013
Will Harris from Terrence Higgins Trust (THT) looks back at the key HIV stories of this year and writes on whether people have a false impression that a ‘cure’ for the virus is just around the corner.
Whenever a story breaks about a potential new ‘cure’ for HIV (and there have been at least six this year), it generally falls to THT to piss on everyone’s chips. We don’t do this to be contrary, or because we’re scared a cure will have us all out of a job (that would be the happiest redundancy process ever); we do it because researchers, with the best of motives, are getting seriously ahead of themselves.
Funding for HIV research is a fraction of what it used to be. With less money in the pot, scientists can view a few good headlines as the thing that keeps a faltering funding stream from drying up completely. This might explain why, for the last few years, researchers have been seeing ‘the cure’ in everything from samples of the virus in a petri dish to animal trials on cats. One recent story trumpeted a ‘promising new vaccine’ when scientists hadn’t even observed how it interacts with the virus; only that someone could take it without keeling over. That’s like claiming your car can reach 110mph because the seatbelt works.
The only thing that can tell us whether a drug is effective is a phase 3 human trial, a stage only a fraction of studies reach. The broader concern is the effect these jump-the-gun ‘cure’ stories are having on people’s attitudes toward the virus. Our new survey of people with HIV reported almost half had encountered someone who believed a cure already exists.
That’s not to say there haven’t been steps forward in research this year. In March, a toddler in Mississippi made global headlines, after an intensive course of anti-HIV treatment apparently cleared her body of the virus. Then in July, two men in Boston were reportedly cured of HIV following bone marrow transplants from donors with an inbuilt genetic immunity.
All these things add to our understanding of HIV, and bring the cure a little bit closer. But we’re still quite some way off. Only in October, a study coming out of the US suggested the viral ‘reservoir’ – the spots in the brain and bone marrow where the virus hides, even when drug treatments have eliminated it from the rest of the body – is up to sixty times larger than previously thought, presenting a major new obstacle for researchers.
The cure we all hope for may still be a dot on the horizon, but 2013 has brought us some welcome advances. Earlier in the summer, the Department of Health announced it was updating outdated regulations around HIV. From next April, surgeons, dentists and midwives with the condition will be able to practice again, so long as they are on treatment and have an undetectable viral load. Restrictions on the sale of HIV self-testing kits will be lifted too, allowing people who want to test at home the opportunity to do so.
Figures released last month by Public Health England suggest that, in the gay community’s ongoing fight against HIV, the community is starting to turn the tide. Testing rates are up dramatically, and the proportion of gay men with HIV who are undiagnosed has fallen to less than one in five. In 2005, that figure was around one in two.
Progress may feel slow at times, but it is steady. Inch by inch, we are getting there. The old messages – get tested, use a condom, stick to your medication – are working. They may not be the shiny cure that gets journalists hot and bothered, but they are the best we have until that day comes.
THT needs your help to promote the facts about HIV this World AIDS Day. Visit www.tht.org.uk/askme to get involved. This article first appeared in QX magazine.
Will Harris works for the Terrence Higgins Trust.