Closer to a Cure?

July 8, 2010 6:49 PM

A summary of two papers on newly-discovered antibodies that can neutralize 91% of HIV strains: "Structural Basis for Broad and Potent Neutralization of HIV-1 by Antibody VRC01" and "Rational Design of Envelope Identifies Broadly Neutralizing Human Monoclonal Antibodies to HIV-1"
posted by anotherpanacea (29 comments total)

gonna be fuckin' in the streets, aw yiss.

Holy HeLa, batman!

The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. The trick for scientists now is to develop a vaccine or other methods to make anyone's body produce them as well.

That's amazing.
posted by boo_radley at 6:52 PM on July 8, 2010

The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as The Invincible Schlong.
posted by Senor Cardgage at 6:55 PM on July 8, 2010 [5 favorites]

as someone who recently lost someone due to HIV, this is good news...
posted by HuronBob at 6:58 PM on July 8, 2010 [2 favorites]

posted by anotherpanacea

eponysterical.

But on a more serious note, if this is something that could really work I hope the clinical trials and what-have-you don't take too long.
posted by wabbittwax at 6:59 PM on July 8, 2010

Please note that super-sweet antibodies aside Mr. 45 is still HIV+. Broadly specific antibodies may confer some degree of protection against HIV infection, but I find myself pessimistic as to how much. Still, a lousy but still minimally effective vaccine may still be epidemiologically useful in some cases.
posted by monocyte at 7:10 PM on July 8, 2010

Holy HeLa, batman!

1. Hope that this leads to a cure or at least, better and longer life for HIV+ folks.
2. Also hope this guy gets some kind of compensation, and not actually just used to make a new, expensive medicine for others to make profit from.
posted by yeloson at 7:27 PM on July 8, 2010 [2 favorites]

The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man

Gibson already did this in Virtual Light. Oh wait.. this is real?
posted by hanoixan at 7:32 PM on July 8, 2010

Back in the early 90's, I once heard a standup comic observe, "On the day they announce a cure for AIDS, if you can't get laid... there's just no hope for you, buddy."

So for me, this front-page post means science is taking us one step closer to... me still sitting at home alone, eating Haagen-Daz and watching reruns on TV.

Ah, progress!
posted by hincandenza at 7:34 PM on July 8, 2010 [2 favorites]

Can this lead to a vaccine that will prevent the spread of HIV, or is it only a potential treatment for people who have already been infected? Better treatments are certainly welcome, but AIDS will continue to devastate poor countries until we have some sort of vaccine.
posted by Joe in Australia at 7:38 PM on July 8, 2010

The caveats are many, but it's still encouraging that a whole bunch of scientists are out there actively and doggedly trying to find a way to defeat this virus. It's good to see any coverage of that aspect of HIV -- the news, to the extent that it pays attention to HIV at all, usually pays attention to only the worst developments.
posted by blucevalo at 7:51 PM on July 8, 2010

I'm very curious as to why this is only effective 91% of the time.

From my understanding of HIV, it always needs to bind to a CD4 receptor and either a CCR5 co-receptor or a CXCR4 co-receptor in order to infect a cell. Maraviroc blocks CCR5, so if your strain of HIV targets CCR5 all the time, then it is effective at blocking the infection of new cells.

If this is blocking the main CD4 receptor, why isn't it effective for every strain of HIV? Are there strains of HIV that don't require the CD4 receptor to enter a cell?
posted by heatherann at 7:51 PM on July 8, 2010 [1 favorite]

Joe in Australia, the articles are talking about using it primarily in microbicides (similar to spermicides, a gel that you could use during sex to prevent infection — there are no effective microbicides yet), and only secondarily as a complement to existing treatment.
posted by heatherann at 7:53 PM on July 8, 2010

I've been out in the streets, waiting. It was cold though, so I've come back inside.
posted by Samuel Farrow at 8:01 PM on July 8, 2010 [2 favorites]

so... which stock should i buy here?
posted by nathancaswell at 8:34 PM on July 8, 2010 [2 favorites]

So the ten percent of resistent strains will take over and we are back where we started
posted by dibblda at 9:18 PM on July 8, 2010 [4 favorites]

AIDS will continue to devastate poor countries until we have some sort of vaccine.

That's really quite optimistic, you know.
posted by ryanrs at 9:44 PM on July 8, 2010 [1 favorite]

MODERN MEDICINE WHAT UP
posted by Pope Guilty at 9:45 PM on July 8, 2010

So the ten percent of resistent strains will take over and we are back where we started

Only if people take boo_radley's comment to heart and go out fuckin' in the streets if this comes to fruition. If people are smart and (relatively) safe, taking out 91% of the reservoir would probably allow us to eradicate the rest in the industrialized world.
posted by Justinian at 9:52 PM on July 8, 2010 [2 favorites]

And by "eradicate" I unfortunately mean eventually the people with the resistant strains would die naturally.
posted by Justinian at 9:53 PM on July 8, 2010 [1 favorite]

HIV evolves extraordinarily quickly inside the host. Typically, initial infection is CCR5-specific. Random mutations in billions of viral copies mean that many closely related strains will be among the population in a single person's infection. In particular, about half of HIV+ patients end up switching from CCR5-specific to CXCR4-specific or viruses that can exploit either of R5 or X4 receptors.

The antibodies here bind the viral envelope surface glycoprotein gp120, which has an extremely variable amino acid sequence, with a few conserved regions necessary for CD4 interaction. So the surprising part is not that 10% can escape, but that as many as 90% can be blocked.

In terms of epidemiology- reducing the transmission rate imperfectly can lead to eventual elimination of the infection from the population. So, leaving 10% can sometimes be good enough (no idea if it is here).
posted by jjray at 10:00 PM on July 8, 2010 [1 favorite]

If people are smart and (relatively) safe

If I've learned nothing else in this life, it's that hoping that people will be smart is a recipe for failure.
posted by deadmessenger at 10:03 PM on July 8, 2010 [4 favorites]

If I've learned nothing else in this life, it's that hoping that people will be smart is a recipe for failure.
posted by deadmessenger

To ensure the strategy works we shall not tell anyone about this. or if that doesn't work-- the Condom of God.
posted by haveanicesummer at 10:42 PM on July 8, 2010

So impervious, she'll remain a virgin.
(Warning: does not prevent conception.)
posted by ryanrs at 12:02 AM on July 9, 2010

For the public health implications of better HIV treatments I do recommend Elizabeth Pisani's The Wisdom of Whores. She has a great blog: Of sex and science. Elizabeth Pisani’s blog about HIV and other sundry things.

She did a twenty-minute TED talk which covers the points of the book. The first half is about intravenous drug users. The second half is about sexual transmission, which means male homosexuals and heterosexuals in sub-Sarahan Africa (but not sex workers, interestingly.)

Essentially, the public health "problem" is that the better you treat HIV, the longer people live and the healthier they are, which means they get more relaxed about HIV infection, which means people are less likely to practice safe sex, which means transmission goes up. I put problem in scare quotes because of course people not dying isn't a problem, it's great. But the effects on HIV transmission are a public health problem.
posted by alasdair at 7:07 AM on July 9, 2010

sub-Saharan, even.
posted by alasdair at 7:21 AM on July 9, 2010

The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man

That read wrong to me. In a humorous way. It read as if "gay man" was the race and "African-American" was the lifestyle choice.

lifestlye choice?!
posted by uncanny hengeman at 8:00 AM on July 9, 2010

If I've learned nothing else in this life, it's that hoping that people will be smart is a recipe for failure.

This needed to be posted one more time.
posted by John of Michigan at 1:14 PM on July 9, 2010

@yelosun Also hope this guy gets some kind of compensation, and not actually just used to make a new, expensive medicine for others to make profit from.

Why? Compensation for what? Sorry, what has this guy done other than to be lucky enough to be born with the ability to manufacture these antibodies? Is there no compensation in knowing that by giving a few blood samples you have saved thousands of lives?
Mr. 45 is not a fucking hero. He's just a very lucky man. The heroes have spent their lives toiling in laboratories endlessly trying one possible cure after another, trying to maintain hope and keeping on working after hundreds of experiments have failed, without any guarantee that they would ever succeed and with the almost certain knowledge that they personally wouldn't be the one to make the breakthrough or be recognised inn any way.
posted by silence at 3:55 AM on July 10, 2010 [1 favorite]

Vaginal gel shows effectiveness in preventing HIV in women
posted by homunculus at 12:48 PM on July 20, 2010