These sort of articles pop up every few months and make people hopeful for a cure, but this is sadly unlikely to ever be a viable one.
Stem cell transplantation is a standard treatment for several blood cancers, but will almost certainly never be a standard HIV treatment for anyone except patients who need a transplantation anyway, for one single reason: with modern medicine, living with transplanted stem cells is significantly worse than living with HIV.
With modern meds, HIV patients can have a normal life expectancy and live basically normal lives.
You know how in traditional organ transplantation, your own immune cells will attack and often destroy the transplanted organ? In stem cell transplantation, your transplanted immune cells will attack every single organ in your body. Look up "graft versus host disease."
After stem cell donation, most patients will have to take immuno-suppressants that a have significantly worse side effects than modern HIV meds do, often for the rest of their lives - and that's the lucky ones, where the meds will successfully treat the graft versus host disease. One of the more gruesome sights I've seen in my medical career was a lady with a severe graft versus host skin reaction that her doctors couldn't get under control despite massive doses of immuno-suppressants. Eventually large parts of her skin peeled off in strips, like something out of a horror movie. Then she died of pneumonia from the immuno-suppressants.
This is an extreme example, of course, and many people live perfectly ordinary lives after stem cell transplantation, but the failure more is both more likely and more gruesome than the one for antiviral HIV treatment.
The avenue towards making this a viable, routine cure for HIV is by performing a “transplant” of the patient’s own immune stem cells that have been genetically modified to carry the anti-HIV genes. That avoids (if done right) the horrific autoimmune challenges you describe, but like everything else it comes with its own technical challenges that are still being worked out. (I think https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935568/ is a good review of the whole idea.) To me (though I’m not an HIV researcher by any means!) this sounds like the most promising shot we have at regularly curing the disease.
>but this is sadly unlikely to ever be a viable one.
I'm not a medical expert by any means, but you claiming this is unlikely to ever be a viable idea makes me think of the sheer number of things we take for granted today in medicine that to a 19th century or even an early 20th century doctor would seem flatly absurd, or completely incredible. A supposition of never makes a bet that one's own limited frame of knowledge, cognitive capacity and imagination has a leg up on all the potential decades ahead of us worth of new discoveries by a vast number of other very clever people. It' s a bet I wouldn't make in my own favor or anyone else's.
This is correct. I have an extremely rare leukemia <1 in 100k, and as said above, the only cure is allogenic marrow transplant. To put it bluntly, survival is at best a 2/3 dice roll - and that's if you're diagnosed before 40.
This is not something you're going to want for something as apparently treatable as HIV.
Not the same as large-scale transplantation, but that reminds me of some work in Chimeric Antigen Receptor (CAR) T-Cell therapy, where the dangerously-useful cells either have a manual suicide-switch or else another method to temporarily deactivate/reactivate them.
So still sci-fi at this point, but I'm imagining some kind of "bone marrow in a box" implant which cages the borrowed immune-system (copied, rather than genetically-engineered) within a barrier that somehow allows only roaming/non-reproducing cells to exit.
This seems like a little bit of a fearmongering. We're slowly understanding GVHD and GVT issues, suppressing one while keeping the other. The frequency of GVHD has been going down over time as we better match donors to the patient.
There are a lot of treatments that started off just like this. For things we thought we would never have a proper cure for, until we gradually understood how treatment worked and how to refine that treatment.
The most House (the TV show)-like case that ever happened in my medical career was the case of the patient with liver failure due to green tea intoxication.
A young man presented in our hospital with acute liver failure. He'd just spent a month traveling through the rain forests of Brazil, Colombia and Peru. During his trip, he'd consumed unknown drugs in a Peruvian shaman ceremony and had unprotected sex with a Peruvian sex worker.
We tested him for everything obvious. He didn't test positive for any known drugs or any obvious drug-related toxins. He didn't have HIV. He didn't have hepatitis A, B, or C. He didn't have EBV, he didn't have CMV, he didn't have Dengue Fever, he didn't have Yellow Fever, he didn't have Malaria. He didn't have any sign of autoimmune conditions.
We called the institute for tropical diseases. We tested him for tropical diseases we'd never even heard of. He didn't have those. He didn't have Syphilis. He didn't have Gonorrhea. He didn't have liver cancer, or any other discernible cancers.
We called the institute for tropical diseases again. They started researching. We tested him for diseases the experts for tropical diseases hadn't even heard of. He had none of those, either.
His liver, which had started failing for no discernible reason, now stopped failing, for equally indiscernible reason. We started planning his discharge.
We had a nice final discussion. He really appreciated how hard we'd tried, he said, and he really appreciated how kind everyone had been, and sorry again about the unprotected sex with sex workers thing, that was effing stupid in retrospect. He said he was looking forward to getting home and detoxing from all this. He said he didn't think the green tea we had on the ward (cheap, shit, comes in bags, unlikely to have ever encountered a tea plant in real life) did anything much, detox-wise, and anyway he'd feel bad emptying our hot water carafe all the time.
Um. How much green tea do you drink, I asked him.
4 to 5 liters per day, he said.
I googled "green tea liver failure," with some vague memory that sometimes tea gets contaminated during the drying process and maybe he'd caught a bad batch? Turns out, green tea just... causes liver failures, occasionally, in higher doses. Probably due to the anti-oxidants.
You live and you learn.
The patient went home and limited his green tea consumption to no more than a cup per day. He checked in with me a year later, because I'd asked him for an update, and his liver was doing perfectly fine and had never failed him again.
4-5 liters! Two liters of green tea typically contains over 400mg of caffeine which is the upper limit recommended for adults. This guy was consuming around 1g of caffeine a day.
I am quite sensitive to caffeine and yet I regularly drink green tea, typically around a liter and never get that weird anxiety I get from too much coffee. Maybe it's just that tea has less...
On the other hand green tea gives me nausea if I didn't eat anything in the morning.
I regularly consumed in excess of 1g of caffeine during my early to mid 20s, either via coffee, green tea, black tea, or mate, or mixtures thereof. I don't think 1g is a very rare dose?
No shame in missing something local among all the exotic red flags, but how does a person consume 4-5 liters of green tea per day to 'detox' while literally in a hospital? Isn't a fluids/diet survey part of admittance?
It's been a bit since my dad was in a hospital, but they wanted to know about literally everything that entered his mouth.
He didn't drink 4-5 Liters at the hospital, just a few (two or three) small cups per day. We'd asked about alcohol and drug consumption, but didn't think to ask about his normal food and drink consumption beyond asking for possible sources of infection (asking about any potential spoiled food or exotic meats he might have consumed.) In retrospect, certainly a big oversight in this case!
That's quite circumstantial evidence though. Nothing in that story tells me you've accurately concluded that it was the green tea.
Patient had unknown liver failure and drank a ton of green tea. Liver failure went away while still drinking tons of lower quality stuff. He proceeded to limit high quality green tea without it coming back, but if it was unrelated it wouldn't have come back regardless if he limited green tea or not.
Oh, and I phrased that badly, but he didn't drink a ton of tea at the hospital. The hot water for tea comes in limited amounts from those samovar type things, and he didn't want to use too much of it, so he only drank 2-3 cups per day.
We were all burningly curious whether the liver failure would come back if he resumed his normal green tea consumption, especially him (very "try everything, you only live once" type of personality; see also, consumption of mysterious Peruvian rain forest drugs), thus proving whether the tea was the culprit or not, but for ethical reasons I had to caution him against experimenting on the only liver he had, and he reluctantly agreed he wasn't THAT curious. Therefore, the cause of his liver failure will never be fully and conclusively proven to be green tea.
Oh, certainly, there's nothing to prove it was the green tea. We did rule out any other cause of liver failure we possibly could, but there's nothing to say we didn't miss something. But green tea in high doses IS a known cause of liver failure (admittedly, not known to us at the time, but there's case studies on pubmed I found once I started searching), so it remained the most likely cause after eliminating anything else plausible apart from the good old doctor standby of "sometimes shit just happens, shrug emoji" also known as "idiopathic."
That's a bizarre line of thought to me. If you build an expensive structure for fortification, you don't usually get to the interior design and then go "Oh fuck it, this extra safety measure wouldn't cost anything, but if they've got this far we might as well surrender, so let's not bother."
Going by that logic, the president's bunker under the pentagon would've been built without a lock. After all, people don't usually have to physically drag a country's leader out of their locked bunker, right? By the time anyone's knocking on that door, usually the war is lost and the country has surrendered.
And yet, if you're designing for defense, why NOT take such a cheap and easy countermeasure as putting a lock on the door or choosing the more defensible way to spiral your staircase? You might want to buy a few more minutes to negotiate in a desperate situation; you might want at least the option of taking that futile last stand; you might be facing not an invading army but a single lunatic with a sword who snuck past the outer guards.
The phrasing of this question seems meant to imply that because one explanation doesn't satisfy you (better diagnosis), it must be the other (vaccines). This sets up a false dichotomy, though--there's no reason it would have to be one or the other.
We know vaccines aren't the cause, because large-scale studies have been done that show that autism rates aren't higher in vaccinated children. This leaves us with basically every other possible cause, including not just better diagnostics (I personally find that explanation highly plausible), but also changes in nutrition, effects of some sort of virus, pollution, microplastics and everything else under the sun that's changed in the last decades.
You don't know that at all.
There were no studies involving all the shots that kids in the US are getting together these days. You are in denial if you don't consider the correlation a possibility. Best take another booster and trust the $cience. Safe and effective.
(Did you have any idea other than "anything but the vaccines"?)
> There were no studies involving all the shots that kids in the US are getting together these days.
It's been decades; the kids are the study. Also, they're no longer kids. Do people who have taken the vaccines report higher rates of autism? It would be relatively simple to check for that.
> Did you have any idea other than "anything but the vaccines"?
Increased awareness of autism, increased medical attention on kids at large, increased medicalization of societal deviance, less socialization, less parental time, environmental factors (more CO2, more exposure to pollutants, more exposure to forever chemicals), dietary factors (more sugar, more carbs, more fat, microplastics), derived factors from any of the above (more screen time, earlier occurence of obesity and diabetes, higher prevalence and normalization of societal deviance).
All of those are as likely as vaccines; which is to say, extremely unlikely. We can test for them. Or we can keep testing this one thing we've already tested for, over and over, until as statistically expected, a study eventually happens to agree with your preconceptions about vaccines, proving the all-encompassing conspiracy of $cienti$t$ and $tati$tic$ and error margin$, and plunging us into another two decades of unvaccinated idiocy.
I assume they're referring to the over a billion people living in China. Whether China is a place you'd want to live depends entirely on your personal cirumstances, of course.
Most wheelchair users are either elderly or suffering from some other deteriorating condition associated with pain, overall weakness, or instability, and will therefore likely not be able to use these. (Note that even in the promotional images, people are using crutches to balance in addition to the exo-skeletons.)
The classic "strong above the waist, paralyzed from the waist down" image of a wheelchair user that people might have from eg the paralympics is the minority.
Not in Germany, they don't. Barmer is a "gesetzliche Krankenkasse"/public insurance, which means most of their members' premiums are legally limited to a certain percentage of their members' income, and while they can and do raise their premiums occasionally, that's always a topic of political debate and needs a better justification than "a very small percentage of our members need expensive exo-skeletons now."
They have no ability to raise premiums on specific members with high healthcare costs.
There's more to the world than the parochial ways of central north america so such locale specific observations deserve to be qualified for the benefit of the wider HN readership.
This isn't meant for heli-skiers who go out with a few thousand bucks of equipment. None of the average hikers I know own a satellite phone, plenty of them like to hike alone, and an hour of walking into the woods (hardly a strenuous hike) will frequently land you somewhere with patchy service (and this is in a country with perfectly well-functioning infrastructure, not the middle of the Rocky Mountains.)
I'm sure this is going to lead to a few spectacular, high-profile rescues, but I'd bet the average use case is going to be "saved me three hours of crawling through the woods on a broken ankle to get back to the last place I had cell service."
I live fifty miles west of a major Northeast city and cell phone is patchy at my house without WiFi assist. I'm sure there tons of spots within an hour drive of my house where I hike that have patchy cell service.
In areas so remote that modern medical treatments aren't available at all, people do often still grow their own medical plants.
If lack of finances is an issue, growing your own herb garden certainly isn't the solution. These plants aren't going to replace a $500 shot of insulin. At best you could maybe replace the occasional aspirin, dramamine, or buscopan, all of which are available over the counter at price points much lower than what it would cost to even buy a bag of quality seeds, never mind soil, fertilizer, and the garden to plant it all in. (Or the time and labor to plant and tend it).
That's already true of most sports, though. There's plenty of mechanical constructs that can move faster than the fastest human. The challenge is to be the fastest human using nothing but a human body, not to outrun a car or a boat (or even a humanoid running robot, which I assume we could build at this point, if anyone was interested in putting enough money behind it.)
Stem cell transplantation is a standard treatment for several blood cancers, but will almost certainly never be a standard HIV treatment for anyone except patients who need a transplantation anyway, for one single reason: with modern medicine, living with transplanted stem cells is significantly worse than living with HIV.
With modern meds, HIV patients can have a normal life expectancy and live basically normal lives.
You know how in traditional organ transplantation, your own immune cells will attack and often destroy the transplanted organ? In stem cell transplantation, your transplanted immune cells will attack every single organ in your body. Look up "graft versus host disease."
After stem cell donation, most patients will have to take immuno-suppressants that a have significantly worse side effects than modern HIV meds do, often for the rest of their lives - and that's the lucky ones, where the meds will successfully treat the graft versus host disease. One of the more gruesome sights I've seen in my medical career was a lady with a severe graft versus host skin reaction that her doctors couldn't get under control despite massive doses of immuno-suppressants. Eventually large parts of her skin peeled off in strips, like something out of a horror movie. Then she died of pneumonia from the immuno-suppressants.
This is an extreme example, of course, and many people live perfectly ordinary lives after stem cell transplantation, but the failure more is both more likely and more gruesome than the one for antiviral HIV treatment.