The statistics are staggering: despite AIDS-related deaths being reduced by 51% since the pandemic reached its peak in 2004, 1.8 million people were still infected with the human immunodeficiency virus in 2017, with close to a million dying from AIDS-related illnesses. A far cry from the “gay cancer” panic of the 1980s, young women in Sub-Saharan Africa, aged 15 to 24 years, are now among the most vulnerable groups to the virus, and are twice as likely to be living with HIV than men.
It isn’t any surprise that speculation about a potential cure to the pandemic always causes excitement, but in a recent article for Africa is a Country, activist and human rights lawyer John Stephens cautions against allowing dreams of a cure to lead to complacency in treating the 37 million people currently living with HIV.
Why “cure” is the wrong word – and why it’s probably far off, anyway
Stephens advises against speaking of a “cure” to HIV, when the better term in the instance of the most recent case would be “remission”.
Just like Timothy Brown – the so-called Berlin Patient – the anonymous London Patient referred to in recent articles about a potential cure was receiving aggressive cancer treatment, necessitating that he stop the HIV treatment he was receiving at the time.
Both men received bone marrow transplants from donors who had a rare, special genetic mutation, called CCR5-delta32. The exact origins of this mutation are still not clear, although researchers suspect its origins can be found at least 2500 years ago, with it ironically playing a role in the outbreak and spread of plagues in the Middle Ages.
Although scientists tried to recreate the results seen in the Berlin Patient, who has been living without HIV for 12 years, it seemed impossible until the London Patient case. Still, says Stephens, throwing around the term “cure” so loosely does little to ensure access to address the plight of close to half of the current HIV-infected population across the world that still don’t have access to treatment.
“[T]his where we are: two people have been cured of HIV, but we (the rest of the world) do not have a cure for HIV. This is not a treatment many people can or should get – bone marrow transplants are expensive, traumatic, and chancy; risking, for example, new cancers, graft-versus-host disease, organ damage, and death. There is a reason we only give bone marrow transplants to people with serious cancer and not to everyone with HIV,” says Stephens.
Current antiretroviral treatment, when taken as prescribed, is extremely effective in reducing HIV to levels that are undetectable. In fact, the latest statistics from UNAIDS state that four out of five people accessing treatment for HIV (or 81%) are virally suppressed.
Current treatments, for all their shortcomings, are still the best way to live a healthy, fulfilling life. And using preventative measures like PrEP, combined with condoms, is one of the best ways for men who have sex with men – whose risk of contracting the virus is 27 times higher than that of the general population – to avoid becoming infected in the first place.