5 ms·

That would be for a cure, but not for a recurrent therapy

• mlrtime 3y ago
  Do we even need a cure or therapy if we can essentially use this as a vaccine? Doesn't help people now, but may eliminate it as a threat for future generations.
  • huytersd 3y ago
    Well you can’t use it as a vaccine since there would be no hiv to preemptively excise.
    • 1letterunixname 3y ago
      What we need is a reliable CRISPR vaccine that confers the CCR5 SNP and essentially give it to everyone.
      • huytersd 3y ago
        Yeah, we don’t even need to get every cell at that point, just a sizable number of the CD4 cells that are relatively easily accessible. The HIV would destroy every CD4 that isn’t CCR5 by itself. The antibodies would clean up the rest of the virons. Theoretically that would work as a cure too if you could excise the hiv and insert the CCR5 widely enough.
• ac2u 3y ago
  Could that risk evolutionary pressure on whatever is left behind so that mutations emerge that are more aggressive?
  • SketchySeaBeast 3y ago
    If we assume that the treatment needs to reach the HIV cell to effect it, and that the danger is not 100% of the cells are reached, would it produce evolutionary pressure? The survivors aren't interacting with whatever got its buddies, right?
    • simcop2387 3y ago
      That itself is an evokutionary pressure. Whatever allowed them to get missed would get amplified by reproduction. Only if it's entirely utterly and only random chance and not something like the method doesn't target certain cells would it not be applying pressure
      • yau8edq12i 3y ago
        If you bomb a cow pasture with napalm, you aren't going to be left with napalm resistant cows. Just lucky ones. And luck isn't genetic.
        • ac2u 3y ago
          You're viewing the cows in isolation here. Replace the cows with cancer cells with different mutations and it doesn't work anymore. There's research going with certain types of cancer where the doses of cancer-killing drugs isn't intended to eradicate all cancer cells, but to keep it at a level that's manageable with future treatments. The theory being that if you go too far, cells that are left with a "lucky" mutation can grow without competition, leaving the patient in an even-less treatable state down the line.
          • yau8edq12i 3y ago
            ... Cancer cells? This is about HIV. What are you talking about?
            • ac2u 3y ago
              you're talking about cows in a HIV discussion, so I could have said "cows and napalm? we're talking about HIV!", but I'm charitably engaging with your analogy to show that evolutionary pressure is an active research area in disease treatment.
        • simcop2387 3y ago
          But there's a chance that any survivors learn to hide from planes and you've now given an evolutionary pressure to cows to hide when hearing airplanes or helicopters. Along with that a pressure that makes the ones that blend in less likely to be spotted to be bombed. So yes, you're right you probably won't get cows that can survive napalm itself but now you've got cows with camouflage and an instinct to hide.
  • throwawaymaths 3y ago
    The selection pressure would have to be some form of resisting the crispr tools from entering the cell or functioning in the cell. The HIV genome is small and I would be surprised if it were so easy for such a thing to come about.
    • ac2u 3y ago
      I'm thinking more of a mutation already present that has less treatable traits but can't spread because neighbouring cells are already infected. But then when the treatment is delivered, it isn't cleared because of the difficulty of the delivery mechanism, but the treatment does clear up the surrounding cells, providing fresh ground for the mutated strain to reinfect. (This is an active research area I've read about in cancer treatment, where it's been suggested that being too aggressive with clearing certain cancers encourages reservoirs of already mutated aggressive variants to be unleashed after treatment whereas before the avenues they had to spread were already infected with the less aggressive variant).
      • tg180 3y ago
        ... and so? Evolutionary pressure is present in any situation and is unavoidable. It still has an effect even in cases where treatments are effective with a success rate of 100%: the selection of diseases for which there is no cure. Entertaining such a perspective can lead to an extreme and undesirable conclusion, that the only logical outcome is to do nothing and dismantle the entire modern medical practice. It's not very constructive.
        • ac2u 3y ago
          Other posters have explained why my concerns aren't warranted for this situation, I'm asking the questions to learn a little. >It's not very constructive. >Entertaining such a perspective can lead to an extreme and undesirable conclusion, that the only logical outcome is to do nothing and dismantle the entire modern medical practice. Disagree, if you read my parent comment in this thread, I talk about the research going on in cancer to account for evolutionary pressure, and the conclusion they arrived at is nowhere near "do nothing". It is instead a change in treatment protocols to aim for less aggressive treatment, the clinic in questions motto is for the patients to die from something other than their cancer by having them on a protocol that has them live permanently with their cancer under the thesis that aggressrive attempts at eradication risk a stronger variant resurging. Obviously it's not applicabale for all types of cancer which is why it's research, and why I'm not telling anyone that evolutionary pressure is a concern here, but am simply asking the question to learn if there are similar concerns between cancer and hiv disease treatments.