By Robert Collins
Good News!
In the early to mid 80s I was living in the Los Angeles area and had the experience of Knowing some of the early AIDS (Acquired Immune Deficiency Syndrome) patients. Then it was Known as GRID (Gay Related Immune Deficiency). The treatments at the time consisted of treating the secondary opportunistic infection. The underlying cause was still unknown and therefore untreatable.
I was at the time horrified at what was happening to my friends. My friend Chris, who was a blonde, blue-eyed, cornflakes type Rid of Scandinavian descent, contracted a disease usually confined to dark older men of Mediterranean descent. Chemo helped, but other infections took root and Chris succumbed in 1983. His death certificate simply said at the time cause of death: Kaposi’s Sarcoma, origin unknown.
In 1986, I moved to the Ohio River Valley area where I grew up and already the impact of AIDS was making itself Known in the area. I became active in the AIDS Task Force Of the Upper Ohio Valley. I specialized in education, giving seminars for sheriffs departments, police forces, hospitals and clinics. I also was involved in seeking and distributing medications for treatment. In September of 1986, the first drug to treat retroviral infection such as HIV was in trials for use by the Food and Drug Administration. Azidothymidine, Known as AZT, offered many the first real hope of long term survival.
The drug was harsh and had numerous undesirable side effects. It was however the only option. Unfortunately, the U.S. supply was limited and expensive. Getting into the trials was difficult. If you lived in certain parts of the country obtaining the drug was almost impossible. A thriving black market flourished, channeling AZT from Mexico and Canada.In 1989, results from a major drug trial Known as ACTG019 were announced. The trial showed that AZT could slow progression to AIDS in HIV positive individuals with no symptoms. The findings were seen as nothing but positive.
Health Secretary Louis Sullivan said regarding this: “Today we are witnessing a turning point in the battle to change AIDS from a fatal disease to a treatable one.” His optimism was short lived when the price of the drug was revealed. At more than $700,000 a year the drug was financially out of reach to all but the richest patients. After much protest, the price was reduced by 20 percent.
This compromise left the drug expensive and still made the black market necessary. From there other drugs were developed as well as strategies to treat the opportunistic diseases prevalent with an AIDS diagnosis. AZT is a nucleoside reverse transcriptase inhibitor (NRTI). In 1991, a second NRTI was approved for use and was offered to patients who showed scant improvement or drug intolerance with AZT. Later in 1991, the two drugs were used in combination creating the first drug “cocktail” used for AIDS and HIV treatment. Patients on the cocktail showed vast improvement although the side effects could be severe.
As time went on and other drugs were developed, combination drugs and once a day treatments such as Atriplia and Triumeq have become the norm, making many HIV positive people have undetectable viral loads. Most people with HIV who are on treatment now have a normal life expectancy with HIV becoming a treatable chronic disease rather than a fatal disease.
In 2003, a new class of drug represented by the drug Enfuvirtide was released. Classified as an entry inhibitor, this drug effectively prevented the virus from entering the cell to replicate. This class of drug was quickly added to the cocktail drugs to increase effectiveness. had an interview with a man, I will refer to him as Joe. His move to the drug Triumeq has changed everything for him. Joe’s numbers are rising, He has an undetectable viral load and no side effects to speak of. Joe’s previous treatment caused bowel problems, anxiety, depression, and sleeplessness.
Trimeq has become a true miracle drug for him.Even as I write this new breaRthroughs are in the making. In 1998, my partner was diagnosed with AIDS. Before his diagnosis we didn’t even Know he was positive. Due to our long term intimate relationship and our sexual practices we assumed I would test positive. I did not.
My partners physician was shocked once he learned about our sexual history. He had me tested again, and then a third time. All tests came back negative. After learning this, he referred me to a study being conducted at Vanderbilt University Hospital of people with known multiple exposures, who did not become HIV positive.
I went every month, was tested, gave blood samples and was examined. I participated in the study for 10 years. Vanderbilt was developing a vaccine for testing, and also began doing DNA testing. They took exhaustive family and sexual histories of me, and also obtained blood from both of my parents. I reported every sexual contact I had to them.
At the end of my participation in the study they informed me that I had a rare genetic makeup where I had two copies of a specific gene. That meant I lacked a cell receptor known as CCRS, making me essentially immune.The finding of this genetic anomaly in me and a few other people in 2002 led to the development of a new type of treatment.
The drug Maraviroc was FDA approved in 2007 and worked using the CCRS inhibitor studies by blocking the HIV from entering the cell through the CCRS receptor, which was the most common route for HIV to enter a cell. The CCRS studies hold promise as a possible route for a cure through means of genetic engineering and splicing. These treatment possibilities are still under study at the present time.
There are other cure options on the horizon as well. In 2008, a man named Timothy Brown underwent a radiation and chemotherapy to Rill his bone marrow while being treated for Leukemia,and then was given a transplant of bone marrow from a donor who was HIV immune because of their lack of CCRS receptors. In one fell swoop Brown was cured of his Leukemia and was cured of HIV infection!
He is as of now the only patient Known to be fully cured of infection. His treatment offers great hope of a cure. The cure is not at this time practical for large scale use due to the lack of HIV immune donors. It is estimated that only 1 percent of the caucasian population carries two copies of the gene in question. With world wide population taken into account, that is one in 70 million people. There just are not enough donors to make the treatment practical on a wide scale. In 2014, Researchers at Tempie University for the first time were able to remove the HIV virus from human cells.
The team headed by Kamel Khalili PhD professor and chair of Neuroscience at Temple and his colleague Dr. Wenhui Hu led the work by developing molecular tools to permanently delete the HIV virus from DNA. From there the cells repair machinery takes over attaching the loose ends of the genome back together resulting in virus free cells.
This in lab work is a huge step in the
direction of a cure. Actual human trials are still a long way off but this breakthrough is the first step in the direction of a practical cure. As time goes on new drugs, new treatments and new channels of research will continue to present themselves. The astonishing conclusion here is the unbelievably rapid progress made in the area if HIV treatment. To the HIV positive it may seem unbearably slow, but from a medical and research standpoint, taking HIV infection from being a disease that Rills within two years to a treatable chronic disease in only a 34 year time span is incredible! Consider this, diabetes is first mentioned in a manuscript in 1500 BC and an effective treatment was not developed until 1921-22.
The unprecedented speed with which this research has moved forward is inspiring and gives us all hope for a better future. Our community will no longer be divided into positive and negative subgroups. We will instead be unified.
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