Every chronic disease has around it a cottage industry of treatments, high and low, that prey on the hopes of the often hopeless. Scarcely a week goes by without a new claim about a promising treatment for cancer or Alzheimer’s or AIDS being just around the corner, often with the majesty of the word “cure” in the headline. These usually work the high-flying science side of the ledger, with talk of genes being folded or unfolded, DNA being spliced, and new Achilles’ heels being revealed, though of course shark cartilage and its descendants are never too far away.
So too are the assertions, once in the backs of magazines or newspapers but now afloat on the Internet, about cures of less threatening but certainly disruptive conditions—hemorrhoids, constipation, heartburn, baldness, low back pain, lower libido. Here the snake oil quotient is a bit more evident than in the skybox seats occupied by insights made using hard science. But the punchline surely is the same: A vitamin, perhaps, or a new salve or a radical change in diet—these simple steps can bring you relief! Today!
So it is with an extremely cautious eye that I read this week of the latest hopeful AIDS cure, a claim from France that two men, unknown to each other and infected 25 years apart, were cured from HIV infection because of an enzyme that, the scientists suggest, precluded the essential replication of HIV. They found traces of the virus spliced into the person’s normal DNA yet could detect no evidence of circulating virus. The two cases were selected from a group of 10 people called “elite controllers,” people who without treatment have no detectable virus in their bloodstream or tissue.
Pretty cool stuff, for sure, and possibly credible. The full article, which appears in the journal Clinical Microbiology and Infection, the house organ of the venerable European Society of Clinical Microbiology and Infectious Diseases, has as a senior author a giant in the field of infectious diseases, Didier Raoult. He also is the editor of the journal, which seems to publish a lot of interesting if preliminary work.
Their premise is completely plausible. With an infection such as HIV, which affects 35 million people today and has already killed millions and millions, it is certain that odd things occasionally will happen. The one-in-a-million chance is exactly that—a small but real chance, as any lotto winner will tell you.
It is surely no surprise, therefore, that something along the lines of what Raoult and his co-workers describe has taken place; i.e., a person or two has been infected by the virus, but the virus never established a foothold in their body. But the authors and the press once again have shown an overeagerness to invoke the notion that this very early, interesting, possibly correct observation would for sure, or almost for sure, lead to a cure, and maybe really soon. It’s like finding a new way to boil an egg and claiming you have found the key to stopping global hunger.
In the rabid claims, the scientists and press have joined a crowded space; there have been other AIDS cure claims. In 2014 alone, we have seen the thrilling “cure” of two babies treated early who in fact were not cured, and the promise of a new approach to treatment, focusing on weak spots in the HIV genome, that would usher in a new day for patients worldwide, and soon-ish.
These investigators, or the swarm following them looking for a read-me headline, seem to have forgotten that not that long ago, HIV was itself in the vitamins-for-baldness, snake oil stage of development. Indeed, in the 1980s many AIDS cures were being touted, including one called MM-1, promoted by an Egyptian rectal surgeon with “unbelievable claims of cure” from his satisfied customers—who only had to fork over $75,000 for the mystery potion. The rumble of headlines this week seems to show that the basic rush-to-judgment itch from the MM-1 days never went really away, it only found classier company.
As I wrote earlier this year, referring to the non-cured “cured” babies, there is real harm in all this blindly and blithely hopeful chatter. Hope, of course, is an essential commodity for anyone facing a substantial illness, and promising developments placed in the not-too-far-off future can become a lifeline for those cornered by a relentless disease. But unsubstantiated hope, hope that rides on the wings of people selling ad space rather than on the shoulders of those making careful scientific observations, represents nothing but a fairy tale. And like a fairy tale, once the fun fantasy has ended, we thud back to the unforgiving and treacherous world of the here and now—which because of the fun distraction feels harsher than ever.
