How far HIV science has come in the 25 years since AIDS was first reported is pretty damn awesome. What was once a death sentence is now, for many, a manageable disease they can live with. It can be diagnosed quickly and cheaply, before doing lasting damage, and then controlled for decades with an arsenal of potent if pricey drugs. Medicine has halted a massacre, handing hundreds of thousands of HIVers the gift of life.
But even at the dawn of the HAART era—when thousands came back miraculously from the brink, and talk of a cure seemed reasonable—most of us held our joy in check, and the celebratory champagne stayed firmly corked. For despite our gratitude, we had seen too much to believe in such a happy ending. Indeed, HAART’s limitations have only confirmed just how far we still have to go. For this month’s cover story, senior editor David Evans mapped that journey, finding surprising news, both good and bad.
Bad news first: Combo therapy may indeed kill the virus, but since it’ll never eradicate HIV entirely from the body, people will have to take the meds every day for the rest of their lives. Doctors assure patients that the meds will grant them a “normal life span,” but as an activist in “Immuno’s Defense” points out, we must take that on faith—HAART hasn’t been tested anywhere near that long. What’s more, the long line of HIVers waiting for government-funded treatment has hit 2,000, and there’s no help on the horizon. (The lack of access in the developing world is a crime.) All in all, it’s fair to wonder just how this tiny virus—little more than a snippet of genetic material enclosed by a microscopic bubble of sugar, proteins and fats—has come to dominate not only our body’s every system but also our planet’s every society.
The good news? Though eclipsed by HAART, new treatments focusing on the immune system, not the virus, are finally showing promise. Indeed, the vast network of cells and stuff that make up the immune system has barely been tapped as a source of treatments. And since the immune system doesn’t mutate as HIV does, these drugs won’t face HAART-breaking viral resistance.
Just as inspiring are the HIVers who’ve played a leading role in immune research not only as advocates but as guinea pigs—by literally putting their bodies on the line. Like Jeff Getty of the famous baboon bone-marrow transplant experiment, they’ve marched into the lab as desperately and courageously as they once marched in the streets, working with the experts, not fighting against them. This bravado was born of the profoundly simple notion that the impossible can be achieved. The complexity of the immune system, much like the stars on a piercingly clear night, can inspire a childlike wonder in even the most jaded. Reawakening that awe, daring the impossible while continuing to put our bodies on the line, will—if anything will—carry us the rest of the way to a cure.