3 ms·

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 t

by 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.
throwawaymaths 3y ago
This doesn't make sense. HIV virus is generally not "substrate limited"/competing with other virii in its propagation in patients in (temporary) remission -- that's basically all of them that don't have AIDS. HIV retro integrates into host DNA and sporadically resurges on a stochastic basis, the drug cocktails in use inhibits this process. Generally the viral load of a patient with HIV is miniscule but must always be kept in check. Note that the point of a crispr treatment is that it would delete dormant HIV sequences that are hiding in the host DNA and not currently producing virii but threatening to pop up at some time in the future. Obviously this too is subject to evolutionary pressures but almost certainly not the ones you are thinking of.
- ac2u 3y ago
  That's good to know thanks, I'm very much a layperson in my readings and was curious as to how it differed.

by ac2u 3y ago

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.

throwawaymaths 3y ago

This doesn't make sense. HIV virus is generally not "substrate limited"/competing with other virii in its propagation in patients in (temporary) remission -- that's basically all of them that don't have AIDS. HIV retro integrates into host DNA and sporadically resurges on a stochastic basis, the drug cocktails in use inhibits this process. Generally the viral load of a patient with HIV is miniscule but must always be kept in check. Note that the point of a crispr treatment is that it would delete dormant HIV sequences that are hiding in the host DNA and not currently producing virii but threatening to pop up at some time in the future. Obviously this too is subject to evolutionary pressures but almost certainly not the ones you are thinking of.

ac2u 3y ago
That's good to know thanks, I'm very much a layperson in my readings and was curious as to how it differed.