Somewhat related I always find the statistic amazing that like 90% of people have EBV (mono) and VZW (herpes, chicken pox, shingles) dormant just waiting for activation.
Now HIV rising up and of course covid will be with us forever as impossible to irradiate once going back and forth between the animal/human population.
At some point science is going to have to find a way to hunt down viruses in our systems, hiding in immune privileged sites where antibodies cannot get to them.
HIV shows how near impossible that task is right now with current knowledge/technology.
Life and dead happens and whatever we try to fix about it will be a pursue of decades/centuries to achive. We're simply more aware about our humanity this days and we're more awaken about how simple is to suffer a terminal illness just "existing" not only smoking, eating fat or living an unhealthy life.
I hope everyone learns about how life and dead works for the human being and not just trying to forget it submerging in an unreal dystopy of pills and pilates classes.
Interested to hear more about those dystopian pilates classes. And to think, I was shelling out my hard-earned money when I could have just been popping pills for the same effect.
I'm not sure hunting down viruses that don't cause problems in 90% percent of people is a good idea. Maybe they have some positive effect that we haven't realized yet.
We are only just now catching up to the idea that bacteria are not always dangerous. There are probably other things we don't know. The tonsils and appendix recently were recategorized from vestigial organs to immune privileged bacteria resevoirs which play significant roles in the immune system.
I think it would be a better idea to try to identify the reasons that some people have adverse reactions and some don't before going into the body and removing things.
EBV is linked to many, many things. But why does it only have these effects in some people and not others? Why is the prevalance of weird EBV-linked conditions increasing with time?
Until these question are answered I don't think it's possible to call it uniquely bad.
Appendicitis is activated by inflammation and "not a problem" for most people. The Appendix organ hides in the body and waits to become inflamed to attack.
It's certainly in the realm of possibility EBV or other viruses have no benefit, but the history of medicine is harmful medical intervention after harmful medical intervention...
In defence of medicine, its history (of the last 100 years or so anyways) is filled with beneficial intervention after beneficial intervention. Never have humans lived longer and healthier, with such low rates of infant mortality and lack of disease.
It's almost certain that EBV has no benefit. We have a nice control group of people without EBV and as far as I'm aware absolutely no benefit is apparent.
Agreeing with you but it's crazy to see people hand-wave "EBV is fine".
Everyone seems to have to go through life the hard way where "nothing is a problem don't overreact" until suddenly it's destroying your life and then it's too late.
EBV can turn to mono and once your body is making auto-antibodies you are screwed for a long time, maybe the rest of your life because your quality of life is just gone. It will keep coming back every time you get weakened.
How about VZV turning into shingles? If you ever had a shingles attack it will change your whole perspective for life on illness and pain. If you could eradicate VZV from your body to prevent that you most certainly should, EBV too.
Indeed. It seems quite insane to me. That a virus that causes hundreds of thousands of cancers and many more debilitating illnesses every year could be reasonably expected to be fine, let alone beneficial is just baffling to me.
The non-carriers are not a control group unless we are 100% sure that the assignment is random. I find it hard to believe when the vast majority of population are carriers.
It's not random. More developed countries and richer people in more developped countries have a lower incidence rate. The chance of catching it increases with age. The part of the population that doesn't catch it seems to be avoiding it by luck, higher hygiene, and fewer vectors. See: https://academic.oup.com/jid/article/208/8/1286/2192838
The first recorded appendectomy is in 1880. Probably the first major study conclusively indicating adverse consequences was published in 2014.
It did hold for a long time, until it didn't because we found scientific evidence that said the opposite. Are you really so confident that no such evidence could ever be found for anything else? There is so much we don't know about the human body.
That's really not it. There is a heavy bias that the appendix is somehow beneficial because we evolved to keep it for some reason (though it could have been just a relic).
EBV is a virus. Our immune system does whatever it can to get rid of it. It causes significant illness. There is absolutely no reason to believe it is beneficial whatsoever.
If you think it is, you can prove it. We have literally hundreds of millions of people walking around that never got EBV. Go on, and find a statistically significant way in which EBV is beneficial for them. You have the burden of proof here.
If that bias is so strong, why did people believe the appendix was vestigial for a 100 years?
If the immue system does "whatever it can" to get rid of EBV, why is it happy to let EBV lie dormant in most people who have it?
Most of what you said can be said about bacteria too. It turns out bacteria can be helpful and blindly applying antibiotics is linked to the rise of numerous autoimmune diseases. It took quite a long time for us to figure it out.
I think the burden of proof is on the people who want to modify other people's bodies (i.e. prophylactic EBV vaccination). You can do what you want to yourself. But unless we want to repeat the mistakes of the recent past we should be ~really~ sure there is no reason the body keeps it around lying dormant. One could even say this is a larger "control group" than the one you are talking about.
Besides, correlational medical studies can't even determine if eggs and coffee are good or bad for you. If we really want to answer these questions adequately, we need better tools.
The immune system isn't happy to let EBV dormant. EBV infects the immune system in order to lie dormant. It hides inside long-lived B-cells in a way that is impossible for your immune system to see from the outside, so there is no way to mount an efficient response at that point.
Again, we knew about side effects for antibiotics from the get-go. It's link to autoimmune diseases specifically is recent because autoimmune diseases were misunderstood. We knew that bacteria could be beneficial and necessary from before we had the first antibiotic.
If we can't tell if eggs or coffee are bad for you, it's because there just isn't a strong correlation either way, and diet studies are not very good at deriving signal.
Thankfully, simply comparing people that are and aren't infected is a much clearer signal.
Again, this isn't hard. We've been able to associate dozens of negative outcomes to EBV infection. We would be able to figure out a positive outcome.
The idea that "the body keeps it around" just completely flies in the face of reality. The fact is, the body doesn't really have a way of preventing it from staying there.
> The idea that "the body keeps it around" just completely flies in the face of reality. The fact is, the body doesn't really have a way of preventing it from staying there.
This is a difference in semantics, not reality. The body also doesn't have a way of spontaneously ejecting the appendix. I would describe this as the body being happy to let it stay there. Of course, sometimes the body becomes unhappy with the existence of the appendix. I think the interesting question is why this happens and the proper treatment is to remove or mitigate these triggers. This is harder than removing the appendix.
We thought there were no serious consequences of antibiotics for a century. We were wrong. As someone living with autoimmune disease, I can assure you that we continue to misunderstand these diseases. I wish I could be so confident that we would never be wrong about anything else ever again. A few days ago there was an article where a virus was used to fight a bacterial infection [1]. How can you earnestly say it's impossible that any virus that makes its home in the immune system could play a role in the immune response? Proving negatives is really hard. Maybe if I saw a 10000 studies that showed no correlation for a wide range of different infections I could be convinced, but our system doesn't encourage publication of negative results so I'm not holding my breath. How many have you seen?
The problem with statistical medical studies is that in general samples are non-random (as you note in another comment) and cannot easily control for any of the 1M (lower bound) confounding variables. Our current methods here are mainly good for p-hacking publications, not uncovering causal relationships or complex effects. This is a discussion for somewhere else though probably.
>We thought there were no serious consequences of antibiotics for a century.
That's not true. We knew there were serious consequences and that microbiome was important from before antibiotics were even a thing.
>The body also doesn't have a way of spontaneously ejecting the appendix. I would describe this as the body being happy to let it stay there.
It has a way of doing so over evolutionary timescales, which is not true for EBV.
>A few days ago there was an article where a virus was used to fight a bacterial infection [1].
That is a bacteriophage. It is a virus that does not infect human cells, but only bacteria. We've known about them for decades.
> How can you earnestly say it's impossible that any virus that makes its home in the immune system could play a role in the immune response? Proving negatives is really hard.
I don't need to prove a negative, you have the burden of proof. It's absolutely certain that has an impact on immune response, we know that, it's just that every single effect we have seen so far has been negative.
> The problem with statistical medical studies is that in general samples are non-random (as you note in another comment) and cannot easily control for any of the 1M (lower bound) confounding variables.
There aren't 1 million confounding variables as far as sampling for EBV. You could feasibly account for all remaining variance, or enough of it to know that it doesn't have a sufficient impact.
We had some minor inklings of the microbiome, but we were not aware of serious consequences. Unless you are accusing the all the governments and medical bodies of the world of gross malpractice.
> It has a way of doing so over evolutionary timescales, which is not true for EBV.
Do you have evidence for this claim?
> That is a bacteriophage.
Do you really think nature has drawn a bright line between viruses than can affect humans and viruses that can affect bacteria? I'm not sure this lines up with reality. People are even seriously starting to talk about the "Human Virome" [1]
> I don't need to prove a negative, you have the burden of proof.
This is what they said about tobacco causing cancer and pesticides killing bees and carbon emissions causing global warming. How did that work out? I'd prefer a more proactive scientific framework than a reactive one. Maybe we could stop the next crisis before it happens.
> There aren't 1 million confounding variables as far as sampling for EBV.
There are 1M confounding factors in sampling outcomes. Not controlling for confounding variables is a great way to get weak conclusions.
> We had some minor inklings of the microbiome, but we were not aware of serious consequences. Unless you are accusing the all the governments and medical bodies of the world of gross malpractice.
That is not true. Microbiome treatments were proposed at the beginning of the 20th century.
I don't see how it would be malpractice. Pathogenic bacteria are a much worse problem than damage to microbiome in most cases. If your microbiome was damaged by evidently useless antibacterial treatments, it could be malpractice.
> Do you really think nature has drawn a bright line between viruses than can affect humans and viruses that can affect bacteria? I'm not sure this lines up with reality. People are even seriously starting to talk about the "Human Virome"
Yes, there is bright biological line between viruses that can infect humans and bacteria. And sure, the human virome could be thing, and certainly natural bacteriophages are important and so are many benign, transient infections important for the human system.
> This is what they said about tobacco causing cancer and pesticides killing bees and carbon emissions causing global warming. How did that work out? I'd prefer a more proactive scientific framework than a reactive one.
Certainly not. Tobacco causing cancer was the default because it is a foreign contaminant in the human body. Insecticides killing bees (insects) is also the default position. Global warming was theorized and predicted since the late 19th century, see Arrhenius, so yes energy companies had the burden of proof.
We already have the priors of EBV causing massive damage to the human body. You're saying that we must prove the negative that it causes nothing beneficial at all. That's akin to saying that despite we know that global warming has many negative effects, we have to show it has no positive effects.
> There are 1M confounding factors in sampling outcomes. Not controlling for confounding variables is a great way to get weak conclusions.
That isn't how statistics work. You can calculate a distribution of impact of every confounding factor onto the measured variance, and from then on you can know if you have controlled enough confounders or not. If you have 999,990 factors that alltogether account for 0.1% of variance, and 10 members that account for 99.9% of variance, you know it's enough.
> If your microbiome was damaged by evidently useless antibacterial treatments, it could be malpractice.
This is how I would describe the vast majority of applications of antibiotics. I'd like to be more charitable and say the people encouraging the use of antibiotics didn't realize the scale of the damage they were causing.
> Yes, there is bright biological line between viruses that can infect humans and bacteria. And sure, the human virome could be thing, and certainly natural bacteriophages are important and so are many benign, transient infections important for the human system.
The human virome ~is confirmed~ to be a thing, and includes bacteriophages. This bright biological line conclusively does not exist. Why would humans evolve to coexist with (or include) a large number of benign viral populations?
> Tobacco causing cancer was the default because it is a foreign contaminant in the human body.
If this is your argument, then what is the default for removing something that is benignly present in the vast majority of people? Surely it should be that it is potentially unsafe, like it is with the appendix and gut microbiome and frontal lobe etc. Anyway this is a historical argument. We've applied huge amounts of pesticides because there was 'no evidence they were harmful.' It turns out this was a bad idea. This framework is clearly very dangerous. Perhaps we should look harder for evidence of harm before we do things.
> That's akin to saying that despite we know that global warming has many negative effects, we have to show it has no positive effects.
Global warming is human-induced change. Removing EBV from the entire human population is human-induced change. The bar for causing change should be higher than leaving things as they are. A better analogy would be removing the appendix. There was no evidence this was harmful for 100 years! That doesn't mean it wasn't harmful!
> You can calculate a distribution of impact of every confounding factor onto the measured variance
In my experience, no one does this. And certainly never with the most important confouding varibables like diet and lifestyle.
>This bright biological line conclusively does not exist.
It does. Bacteriophages cannot infect human cells. They can only do it by changing our microbiome.
>If this is your argument, then what is the default for removing something that is benignly present in the vast majority of people? Surely it should be that it is potentially unsafe, like it is with the appendix and gut microbiome and frontal lobe etc. Anyway this is a historical argument. We've applied huge amounts of pesticides because there was 'no evidence they were harmful.' It turns out this was a bad idea. This framework is clearly very dangerous. Perhaps we should look harder for evidence of harm before we do things.
EBV causes millions of cancers, and it seems that it is likely to cause millions of cases of autoimmune diseases. It is known to cause vast amounts of harm. By the same logic. Beyond this, a large proportion of viral infections of EBV cause mono, which in and of itself is a great harm. You can't ask that every future intervention prove a negative.
> In my experience, no one does this. And certainly never with the most important confouding varibables like diet and lifestyle.
Is your theory that for some diets and lifestyles, EBV has beneficial effects? You can certainly design a study to account for this.
no, that varies by communities of people, defined by a graph of their location, hygiene and intimate practices. I can say that a different percentage probability applies to the graph of Orthodox Hasidim in Brooklyn versus the graph of professional basketball players in the USA.
The viruses listed by parent aren't spread sexually, though they are all herpes viruses.
EBV is also known as HSV-4 and gets to 60% plus prevalence in children, 90% in US adults. If there are populations with especially low prevalence I'm not aware of it.
HSV-1 which causes mouth cold sores is present in 50-80% of people, also easily acquired in childhood. Only 20-40% of infected people get cold sores so most infected people don't realize they have it.
Chicken pox/shingles is also a type of herpes virus with well known massive prevalence!
Genital herpes is just one of many types of herpes viruses that affect humans.
> A highly transmissible and damaging variant of HIV has been circulating in the Netherlands for decades
Note the for decades. With all the worry about Covid variants, these headlines are more attention grabbing, but I'm not sure if this would make the rounds if Covid wasn't a thing.
Is this strain properly detected by current HIV tests? If that's the case then we already have statistics about the HIV epidemic. No need for speculations.
A new strain, due to nature of exponential growth, can spend a long time before it noticeably moves the total number of cases and causes people to notice change.
Think about it this way:
Year 1) 10.000 normal cases + 1 new = total 10.001
Year 2) 10.000 normal cases + 10 new = total 10.010
Year 3) 10.000 normal cases + 100 new = total 10.100
Year 4) 10.000 normal cases + 1.000 new = total 11.000
Year 5) 10.000 normal cases + 10.000 new = total 20.000
Year 6) 10.000 normal cases + 100.000 new = total 110.000
You see how for a long time, if you were looking at a total number of cases, nothing was happening and then it suddenly became absolute, unmitigated disaster?
This is one of the unfortunate characteristics of exponential growth. If there is a new exponential growth that is masked by noise -- it could be very invisible for a long time and then suddenly become a huge problem.
---
Edit: here another example with more realistic reproduction rate (2x annually and delay of 5 years before developing symptoms)
Year 1) 10.000 existing steady state + 100 new = 10.000 with symptoms
Year 2) 10.000 existing steady state + 200 new = 10.000 with symptoms
Year 3) 10.000 existing steady state + 400 new = 10.000 with symptoms
Year 4) 10.000 existing steady state + 800 new = 10.000 with symptoms
Year 5) 10.000 existing steady state + 1.600 new = 10.000 with symptoms
Year 6) 10.000 existing steady state + 3.200 new = 10.100 with symptoms
Year 7) 10.000 existing steady state + 6.400 new = 10.200 with symptoms
Year 8) 10.000 existing steady state + 13.000 new = 10.400 with symptoms
Year 9) 10.000 existing steady state + 26.000 new = 10.800 with symptoms
Year 10) 10.000 existing steady state + 51.000 new = 11.600 with symptoms
Year 11) 10.000 existing steady state + 102.000 new = 13.200 with symptoms
Year 12) 10.000 existing steady state + 204.000 new = 16.400 with symptoms
You see, adding a delay to symptoms of exponential growth makes it even more heinous.
Year 11 when a somebody that watches statistics of symptomatic patients might notice a rise is already when you have over 10x more new cases than the steady state you think that is happening.
We could complicate this example (some cases get symptoms earlier than 5 years, etc.) but the basic reality is still the same -- when there is a noise and the signal is delayed, the moment you notice a rise in total number of cases and you suspect it being caused by an exponential growth, you should be worried that the reality is much, much, much worse.
Hope you realise that mine was completely made up example just to show the basic characteristic of exponential growth in presence of static component.
I chose 10x growth factor to make sure the reader gets a point you can have absolutely disastrous epidemic brewing and still be invisible for many years.
With smaller reproduction rate and other confounding factors detecting a new epidemic like that could be even more difficult if you only look at total number of cases.
If it doubles say every 18 months numbers get really obvious before the number of cases dwarfs exiting new cases let alone existing cases. Something like 3-6 years warning before the number of new cases double. T minus 6 years it’s a 6.5% bump, T - 3 years it’s a 25% bump, T-18 months it’s a 50% bump.
For a disease like HIV where existing cases dwarf new cases you get a lot of time to prepare before the number of existing cases significantly increase.
It’s particularly interesting because the trend with HIV so far has been towards less damaging variants, not more. Fatality rates for HIV are almost at point where there’s no longer any reduction in life expectancy, due to mix of better medicine, but also due to HIV evolving into less deadly strains.
To see a reversal in this trend is extremely note-worthy, and somewhat worrying.
> It’s particularly interesting because the trend with HIV so far has been towards less damaging variants, not more.
False. HIV is as deadly as ever.
> Fatality rates for HIV are almost at point where there’s no longer any reduction in life expectancy, due to mix of better medicine
True. It is due to improved treatments, which are a mix of medicines (where the mix is designed to inhibit the development of resistance to the full cocktail)
When making statement like this in a political environment like ours you should consider the facts that underpin this. With the great majority of people practicing safe sex, there's evolutionary pressure on the virus not to kill its host before a passionate slipup, which may well be 10 or 20 years. Also, there's very effective medication available. None of these facts is true for covid. There's no pressure at all for the virus to become less virulent, it's an airborne disease, and what medications are available are not particularly effective.
Majority of people who practice safe sex do not affect HIV transmission. HIV transmits mostly through networks of people who do not practice safe sex.
Unlike a normal virus where people exchange it at random, here people that are more likely to get the virus also seek out other people that are more likely to get the virus. Normal r-value calculations do not apply because you no longer have homogenous population.
You do not need a lot of these people to keep the virus alive. A person that practices unsafe sex once is more likely to do it more than once, with other people who will do the same. In effect forming a network within general population.
While people who practice safe sex might become collateral damage (like spouses of people who practice unsafe sex or patients at a clinic that used untested blood) they are very unlikely to transmit it further (safe sex practices are very effective at preventing spread of HIV).
Also no need to bring politics to it. Viruses do not care about politics.
Most people do not immediately go for comprehensive testing the moment they feel worse for a little bit. And most doctors that see flu-like symptoms will assume you have a flu.
The reality is that almost every person diagnosed with HIV is diagnosed because:
1) They developed full blown AIDS
2) They got contacted by somebody who just discovered they have HIV/AIDS to get checked
3) They went through some routine unrelated test (for example they wanted to give blood)
Routine full panel std checks when you have a new partner or if you have an accident like say when visiting a sex worker are a thing, enough that you can order one at a bulk lab diagnostics service for relatively little (it's still expensive but not prohibitively so, and some nonprofits offer them for free)
People are offered life saving vaccines for free and still don't take it.
I don't want to throw completely baseless statistics, but I would guess over 95% of the world either a) does not have access to that kind of thing, or b) has other priorities, financially, or c) does not care about this because they are either not informed or they know this exists but is not important enough for them to actually do it.
And if you are from US remember, western countries where these things are easily available and people can generally afford it are only small percentage of the world's population.
Op was about circulation in Europe, where I am guessing they have these things.
And if people are not doing it enough in western nations where we do have access, then my posting this serves to increase awareness in this small hn community.
HIV is not transmissible via the air. You don't get infected just by visiting a restaurant. You can't even get it by touching surfaces or someone who has it. You need to exchange blood or have sexual intercourse.
I can choose to not have sex or wear condoms. I can also make sure to use clean needles and I know that if I were to get a blood transfusion it is checked to be "clean".
I can't choose not to get in contact with COVID if I leave my house.
Off tangent but I’m kinda curious how the Moderna vaccine will play out. I don’t understand the subject enough so would love to hear others thoughts on it. From what I can tell, rather than making our immune system respond to the spike protein like the Covid vaccines, it tries to make our B cells react to HIV that’s usually “undetectable” by our immune system.
> Off tangent but I’m kinda curious how the Moderna vaccine will play out. I don’t understand the subject enough so would love to hear others thoughts on it. From what I can tell, rather than making our immune system respond to the spike protein like the Covid vaccines, it tries to make our B cells react to HIV that’s usually “undetectable” by our immune system.
Are you talking about an unreleased Moderna HIV vaccine? I'm pretty sure you are, but when you say "Moderna vaccine" most people will read that as Moderna COVID vaccine, because it's been released and widely administered. It's too easy to read your comment as implying the Moderna COVID vaccine has some kind of anti-HIV component.
I need to research more about the vaccine, but as far as I know the issue with HIV is that it not only injects genetic code into cells like most viruses, it integrates into the DNA of your T-Cells. Even if you eliminate all viruses, your own cells will produce more from scratch because they blindly follow the blueprint.
So I really want to learn more about how this vaccine works.
Covid is not commonly spread in restaurants either. Less than 1.5% of Covid infections contact traced in NYC were attributed to bars or restaurants, according to the NYC Department of Health.
That sounds like a testament to a successful policy of checking vaccine card. That study would be more illuminating if it were done in some place with no checks.
As I understand the theory here is that humans develop antibodies against the parts that mutate making our immune system ineffective, while a vaccine could teach the immune system a better part to identify against.
How many people are effectively managing the disease now who would have died 30 years ago? Perhaps you should be less glib out of respect for their lives.
You're responding to somebody mentioning that a cure has been announced as being immanent a dozen times, not somebody who is denouncing medicine in general. No need to attack unless you actually disagree.
It's not an attack to remember that medicine is about saving lives: changing HIV from a death sentence to a daily pill was _huge_ improvement for people and it feels quite weird to act as if nothing changed.
> How many people are effectively managing the disease now who would have died 30 years ago? Perhaps you should be less glib out of respect for their lives.
I don't think the parent commenter was being glib. Treatments are great, but a treatment is not the same thing as a cure. Lots folks successfully treat their diabetes, but I'll bet most of them would prefer a cure for diabetes.
No question, but that doesn’t make science hype just because it didn’t produce a cure by the end of the episode. Just in case it wasn’t clear, I’m explicitly calling out that choice of wording. If they’d said “this is a notoriously hard problem”, I’d agree.
They're different but not completely so: what I'd look at is the cost to someone's life. For example, glasses don't “cure” bad eyesight but they lower the impact down to the point where most people don't care. Type 1 diabetes used to be a death sentence, it's still uncurable and while it's not fun to have I know plenty of people would have died before graduating high school a century ago who are living normal lives, raising children, etc.
Similarly, when I was growing up HIV was a death sentence and it was tearing through many social groups. The gay friends I have, especially the slightly older ones, have talked about the trauma that caused because their social networks were decimated _and_ a lot of people blamed the suffering on them. Now, it's not ideal to be on medication but it means that people are reaching close to average longevity with far more manageable health impacts — again, not perfect but decades of extra time with friends and family is a transformative change.
What about dismissing decades of hard work by many thousands of people as “hype”? There've been a lot of disappointments along the way but it's not like these were the people pushing Ivermectin as a COVID treatment — a ton of scientific careers have been spent working on this and it seems far too glib to brush that away as if there isn't a life-changingly better prognosis for someone who learned they were infected today compared to 30 years ago.
Don't believe the hype is a common expression in English. You are just reading much too much into it IMHO. And I don't like to see discussions derail into this.
If you're familiar with the expression, you're also familiar with it having a connotation of something being oversold, usually for reasons of sales or politics. I don't think that's a fair way to describe good faith scientific research into a hard problem.
You've had three, (now four) people explicitly mention that your comment was needlessly hostile. To each of those people, you've responded defensively.
I would suggest that you carefully review what was written, what you wrote, what the feedback from it was, and consider if there is room for improvement rather than just digging in.
Since your reply was cordial, I'll note that I probably would have used wording to make it more clear that I was specifically unimpressed by the use of terms like hype or what read as the implication that there's been a widespread representation that a cure is close. I've typically only seen that in the context of the various scam claims over the years, not mainstream research — the coverage I've read since at least the 90s always mentioned it as a very hard target a long time off.
Maybe I'm a bit biased from having worked at some places where researchers were working on problems like this but it felt unfair to focus on that but not mention that there are now mainstream treatments developed as part of that work which have made a huge improvement for millions of people globally.
While PEP/PrEP is not a cure for HIV infection it both prevents AIDS and suppresses HIV so far that patients are no longer infectious. This solution is real, proven and available and is applied in practice right now. The only practical difference between this and a vaccine is that the user has to keep taking medication.
Could someone with more knowledge explain to me why a vaccine against HIV would not also be a cure?
If the body has antibodies against HIV so you can't get infected, it should also be possible to kill HIV as well when you are infected? Especially since the vaccine targets a structure which the normal immune protection normally doesn't target?
Protection from infection is sort of like cleaning up a spill on your doorstep. Curing an active infection is more like cleaning up after someone deliberately blew dirt throughout your whole house, and hid some extra in nooks and crannies.
A vaccine has the potential to give you enough of an immune response to prevent an infection. But eradicating an existing HIV infection is a very different problem. The virus lies dormant in large quantities, and your immune system will only attack the virus that’s “awake”. The current research for a cure is focusing on eliminating this viral reservoir. While your immune system could theoretically keep the active HIV at bay, leading to a functional cure; we’ve never seen this play out (other than in Timothy Ray Brown). HIV always wakes up, and replicates faster than your lymphocytes can kill it (while using your immune system as a virus factory).
Now HIV rising up and of course covid will be with us forever as impossible to irradiate once going back and forth between the animal/human population.
At some point science is going to have to find a way to hunt down viruses in our systems, hiding in immune privileged sites where antibodies cannot get to them.
HIV shows how near impossible that task is right now with current knowledge/technology.