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HIV strain and cure
May 28, 2014

Dear Ben

Hope u are in the best of health. Am from the sunny island of Singapore.

Just curious how do different strains of HIV affect people differently. I have seen HIV+ people who are in excellent health and some with very poor health. Could it be due to the type of HIV strain they carrying ? They seem to be having same CD4 and same time diagnosis.

What are the chances of a HIV cure by 2020? Seems like AMFAR is targeting 2020 to find a cure (functional) for AIDS. While Gallo, one of the founders of HIV virus has said confidently that a functional cure is possible within 5 years provided the various bodies work together towards finding the cure.

I am optimistic that by 2020 we will have something that will act as a functional cure. Probably it might be costly medication and will only reach to the elite groups of people, but in a few more years like 2030, will reach to the masses. What do you think ?

Response from Dr. Young

Hello and thanks for posting.

Fortunately, unlike hepatitis C, HIV medications work similarly for all strains of HIV-1. People do have different trajectories of health, and some viruses appear to be more pathogenic than others, but this is less about the strain and more about the individual virus.

As for cure, I think that we're on the threshold of HIV cure for infants-- potentially millions of them. Two appear to have been cured with medications that we already have. Already.

It will be somewhat longer before we have cure strategies for adults. As for 2020, I'm less certain, though functional cure is certainly closer at hand than eradication. Indeed, I've stated elsewhere that we sort of have a functional cure already- single pill a day ensures health and prevents death. Is this a functional cure? Or would an injection once every 2 or 6 months be a functional cure? The later is possibly in the near term future.

Cost of any of these strategies will be problematic, just as they are for the curative HCV medications. How much would a HIV cure be worth? How much return on investment would the shareholders of manufacturers insist upon? I'm don't have these answers, but it's unlikely to be cheap or free.

Either way, I'm cautiously, but very optimistic for the future. BY



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