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Doctor not believeing in Gene Therapy / puts it down as quackery
Apr 11, 2008

Recently I approached the topic of Gene Therapy with my doctor and he simply put it down as unproven science and classified it in the category of other previous quackery in treatment for HIV. Is he just out of touch or too busy to stay atop of current research that may be successful?

Response from Dr. Sherer

You should explore the topic further with your doctor. More likely you are simply misunderstanding each other's position.

While you are correct that there are many fascinating advances in our understanding of the role of human genetics, including pharmacogenetics, in HIV medicine, he is right that there is as yet no established role for 'gene therapy' per se, i.e. the insertion of genes in order to prevent or mitigate the consequences of HIV infection, or HIV infection itself, for use by HIV clinicians today.

Perhaps the most significant genetic issue in HIV medicine at present for the practicing physician is the recent identification of the close association between the HLA B*5701 haplotype and abacavir hypersensitivity reaction. For the first time, clinicians can screen patients for this genetic marker and thus avoid a serious and potentially life threatening adverse drug reaction. That is not 'gene therapy', but it is the screening for a genetic pre-disposition to a known life-threatening adverse effect.

There are important contributions of host (human) genetics in a variety of other HIV-related conditions, including the pharmacology of efavirenz in various race/ethnicities, the incidence and prevalence of the metabolic consequences of HIV infection, and the acquisition of HIV infection.

There are other more innovative genetic manipulations to alter the host response to HIV infection, as well as for other diseases, that are being investigated. While promising, they are indeed experiemental and of unproven value for the care of HIV infected patients.

So I suggest you talk further with your doctor. If you think you have information about exciting experiments on gene therapy in HIV medicine that he should be aware of, print out the abstracts or papers and take them to him. I would agree with you that these have risen to a level of credibility that is well beyond 'quackery', but I would encourage you to respect the inherent skepticism of the HIV primary care clinician. You and he have excellent proven tools at your disposal with which to manage HIV infection, and they do, and they should, require your doctor's full attention.

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