A cure for HIV?

(The "cure" for HIV isn't Ensure, but more on that later.)

I'm back at work after a week of vacation and this week I am working in the HIV clinic. One of the first patients I saw this morning mentioned that he had seen a TV segment about a cure for HIV.

The attending that I was working with starting talking about this story. Basically, 1% of Caucasians are naturally resistant to HIV infection because of a mutation in CXCR5 which is a co-receptor for HIV infection. An HIV positive patient developed leukemia and required chemo and a bone marrow transplant. His doctor screen the marrow banck for a match that had this rare mutation, and it managed to eradicate HIV the patient's body. He was functionally cured. However, this is not applicable for the population at large with HIV. Finding a donor with the mutation who is also a match is very rare, and it would also have to be a patient who already had leukemia and was getting chemo anyways - otherwise you would be giving chemo and bone marrow transplants with HIV patients who could be treated with meds.

I talked about this with some of my coworkers and lunch and both the guys on either side of me said they would get chemo and bone marrow transplants if they ever developed an HIV infection. I was amazed. They would go through all that for a disease that we now manage so well with meds that HIV patients have a normal lifespan? I'd take the meds unless I had leukemia on top of HIV.

They also brought up the idea of giving incentives to donors who had this mutation in an effort to get more bone marrow donors. Now that's not a bad idea.

However, what the patient was actually talking about was this. It's a story about how a constant region in of HIV was discovered and how abzymes can be employed against it. However, this constant region could change once the virus mutates.

On an unrelated note, I had another patient today who came in asking for Ensure because he was too lazy to cook and he was trying to gain weight. I was then surprised to learn that "Ensure has street value" as my attending told me. It is highly popular in the Latino community and is seen as something that can be taken to make you healthy. Patients with a prescription can get it for free from Medicare and they can then sell it at a discount to a merchant who will sell it at retail value. Sneaky....