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HIV vaccines and generic meds
May 24, 2005

I have HIV and my partner is negative. Before I knew I was infected we had years of unprotected sex. He is still negative, and we always use condoms. I am curious though if there some gene that keeps some people from getting HIV. And if research is being done on that to help find a vaccine. When I was diagnosed I had a CD4 count of 10 and high viral load. He tested negative even after all tests of window period. I am really curious if he has some kind of gene and the effects of that in them finding vaccine?

One quick question are they ever going to get generic meds out at cheaper costs?

Thank you.

Response from Dr. Conway

There are a number of people who are exposed to HIV and who do not ever get infected. There are 3 possible explanations for this.

First, it may just be that, statistically speaking, your partner has not yet become infected. You can be exposed many, many times before becoming positive. For example, a male can be exposed to an infected female over 1,000 times before the risk of seroconverting exceeds 50%. It may just be that your partner avoided infection before your diagnosis was made, and now that you use condoms all the time, he continues to avoid infection due to the lower risk behaviours you employ.

Second, it has been shown in some groups of prostitutes in Kenya that the more different they are from the general population (by tissue or HLA typing) the more likely they are to avoid being infected by HIV. This is probably because their bodies more easily recognize the cells of their sexual partners bodies as different and destroy them before the HIV that is contained in the genital secretions has a chance to infect them. This is interesting in that it protects them (relatively speaking) from HIV in that environment, but may not do so in other settings.

Third, it may be that your partner is able to mount a very effective immune response against HIV and defend himself against it despite repeated exposures. If this is the case, what is happening in your partner is very important to recognize and measure, as this is the kind of "protection" we would want to generate in an HIV vaccine.

As for cheaper generic drus, many are already available in developing countries. I am sure that as the patents on the drugs we use in the Western world expire (zidovudine being the first, next year), cheaper generic versions will be made for use here, although probably not as cheap as they are in the developing countries.



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