A Cure For Aids?
Courtesy of Robert Silman, redOrbit contributor
A long while back, right at the start of the AIDS epidemic in the late 1980s, I thought Iâ€™d found a possible cure for AIDS. Though I was a medic and research scientist, working at St Bartholomewâ€™s Hospital in London, I was never much good at lab work and relied heavily on my colleagues who were much better than me at the practical side of things. I tended to find things in my head and then fail to discover anything when I actually did the experiments. For example at the start of my career I was sure Iâ€™d found the cause of toxaemia of pregnancy, yet in twenty years of lab work I was never able to prove it. So when I say Iâ€™d â€śfoundâ€ť a possible cure for AIDS, there was lot of lab work to do before I could say Iâ€™d definitely â€śdiscoveredâ€ť anything. And with my history, it was going to be a long wait!
Whatâ€™s more, even if Iâ€™d wanted to undertake the experiments which could test my idea, it wouldnâ€™t have been allowed. My speciality was neuro-endocrinology (hormones of the brain), I wasnâ€™t a virologist or infectious diseases person. In science, you donâ€™t swop specialities in mid-stream. Indeed I was straying over the boundaries just in thinking I might have had an idea in someone elseâ€™s terrain.
Before I start on the idea itself, it might be useful to have what in legal documents are said to be an agreed â€śStatement of Factsâ€ť, i.e. those things about which both sides of a legal dispute can accept without argument. There are only three such facts which underpin my idea; they are the cause, prevention, and treatment of AIDS:
â€śAIDS is caused by a virus (HIV) infecting blood cells (T Cells) and destroying them.â€ť
â€śAIDS is prevented by: i) stopping HIV entering the body; (e.g. non-infected sexual partners, non-infected blood transfusions, condoms, etc.); and/or ii) after HIV enters the body stopping it from infecting T Cells with an effective vaccine (not yet developed).â€ť
â€śAIDS is treated by anti-viral drugs which slow down/stop the destructive activity of HIV on T Cells.â€ť
Scientists have developed ever better anti-viral drugs to treat AIDS, but still we have no cure. Giving insulin to a diabetic is a treatment not a cure. If you stop the insulin the diabetes returns. Likewise antiviral therapy for AIDS is a treatment not a cure. (Note 1).
So why in the late 1980s did I think Iâ€™d found a possible cure? It came out of the answer to a question which was puzzling me, namely:
â€śWhy does HIV exist?â€ť
Now I guess you can ask that about anything. But in a scientific context, there was a good reason for asking this about HIV. HIV shouldnâ€™t exist because it kills its victims. It is such an effective killer, it should end up by killing itself in the process.
What I mean is that HIV is not like a common cold bug which leaves its victims alive, ready for reinfection at a later date. Nor is HIV is like the syphilis bug which spreads slowly via sexual intercourse but which does not kill its victim during his/her reproductive life, thereby giving the victim time to transmit the bug to a new victim and the new victim to other new victims ad infinitum. HIV is more like the bubonic plague, a bug which kills its victims rapidly and which finally ceases to infect humans by running out of victims to kill through mass extermination or quarantine (e.g. the Black Death). But mass extermination/quarantine also kills the killer. If there are no further victims to kill, the killer has nowhere to live and therefore exterminates itself. In the case of bubonic plague, the bug continues to survive only because it has fleas and rats to prey upon until the time is right to reappear and strike a new human population (e.g. the Great Plague of London).
So my question â€śwhy does HIV exist?â€ť needed to find its answer in wherever HIV was hiding before it struck and caused the AIDS epidemic of the 1980s.Â In those days there was speculation that HIV might have had its origin in Africa, perhaps crossing species from monkeys to man, a Simian SIV to a Human HIV (Note 2). But my thought was that if HIV had behaved in those early African populations as it behaved during the AIDS epidemic, there was even less chance that it could have survived. It would have killed its victims even more effectively in a small isolated African village population and therefore even more reason for it to be extinguished in the process.
My thoughts took me to the idea that HIV might be like Sickle Cell Anemia (SCA). SCA is a severe blood disease which kills. Consequently the genetic mutation which gives rise to SCA should have been selected against and become extinct. However, the reverse is true. Instead of dying out, SCA flourishes to such an extent that in certain areas (Africa) the SCA gene is present in 10 percent to 40 percent of the population. And, the reason why SCA continues to exist is because individuals who carry the sickle cell trait are highly protected against malaria. This explains why a deadly mutation continues to survive, and why it is prevalent in areas where malaria is endemic. The SCA mutation is a pathogen in its own right but it is also a counter-pathogen to another disease; i.e. its pathology in provoking anemia is outweighed by its advantage in combating malaria. So back in the late 1980s I asked myself:
â€śWas there some possible advantage to being infected with HIV?â€ť
In other words, did HIV exist because it was a counter-pathogen to some other disease?
But what possible benefit could HIV confer? And this is where I have recourse to the first Statement of Fact, namely â€śHIV destroys T Cellsâ€ť. My childishly simple train of thought was:
â€śIf HIV exists because it is of benefit in countering the effects of another disease, maybe that other disease is one which multiplies T Cells.â€ť
My thinking ran something like this: if you have a disease (AIDS) which results from the destruction of T Cells and you have another disease (Leukemia) which results from the overproduction of T Cells, maybe (just maybe!) the two diseases hold each other at bay.
But what is this disease which multiplies T Cells? It is called adult T-cell leukemia (ATL), a disease characterized by an unregulated over-production of human T cells, first reported as a distinct clinical entity in 1977, and in the 1980s discovered to be caused by a virus! The virus was called human T-cell leukemia virus (HTLV) with each strain designated as HTLV-1, HTLV-2 etc. There are approximately 10â€“20 million HTLV-I carriers in the world. It is endemic in Japan, parts of central Africa, the Caribbean basin and South America etc. In the early years of AIDS research a prominent scientist, Robert Gallo, believed that a variant of HTLV might be responsible for AIDS. This was finally disproved when it became evident that the true cause of AIDS was HIV, a totally different virus. (Note 3).
So here was my possible cure! If someone was dying from HIV, inoculate him/her with HTLV. (And/or if someone was dying from HTLV, inoculate him/her with HIV). I did say it was childishly simple. But, if true, it would be a cure not a treatment. One or two simple inoculations could in principle hold the disease(s) at bay indefinitely.
I tried to plant the idea with some of my colleagues who were working in the AIDS area. Though they listened politely, I sensed they thought I was ignorant and/or mad (at best, eccentric). So I thought up a ruse which I hoped might spark an interest in the wider scientific community. I would write a medical thriller about an insanely ambitious psycho scientist who steals and kills his way to the Nobel Prize by discovering the cure for AIDS. And guess what cure? HTLV obviously!
I wrote the book with a co-author (thatâ€™s another story). It was titled â€śThereâ€™s A Bug Going Aroundâ€ť and in the 1990s it was sent to all the major publishers. They all repliedâ€¦ Rejected! I did make a discovery all the same. There is only one way to say â€śyesâ€ť, but hundreds of ways to say â€śnoâ€ť.
The idea lay dormant in my mind and the book in the backwaters of my computer until last December when a friend, whoâ€™d read a draft of the book way back in the 90s, phoned me. The conversation (in French, sheâ€™s a French friend) went like this:
French Friend: Robert, you remember the medical thriller you wrote about using the Leukemic virus to cure AIDS?
French Friend: Well Iâ€™ve just read that someone has used the AIDS virus to cure Leukemia.
And it was true in a way. It wasnâ€™t exactly what I was proposing in my book. In the clinical case which was being reported, it was a modified form of HIV that had been used and the Leukemia was not due to a virus. But it got me thinking again about my long lost cure for AIDS. In the late 1980s, I had suggested that you could easily test my idea with co-infection studies; i.e. studies on patients who were found to be i) infected with HIV alone; ii) infected with HTLV alone and iii) co-infected with HIV and HTLV. If I was right, the first group would be at risk of developing AIDS, the second Leukemia. However, the third group should be protected from both AIDS and Leukemia. The success of anti-viral treatment render co-infection studies of little use today since it masks the effects (beneficial or otherwise) of co-infection. But, after my friendâ€™s phone call, I decided to take a look at what had been happening in the area of co-infection and, to my amazement, I found there were studies which suggested I might have been right all along:
â€śHIV-1 and HTLV-2 co-infections have been linked in some cases to a long term non-progressorâ€ť (Note 4.)
A Â â€ślong term non-progressorâ€ť is an HIV infected patient who maintains normal T cell counts and AIDS-free survival indefinitely. In other words, this was exactly what I was predicting.
Of course if this is the case, i.e. if HIV is a counter pathogen for viral Leukemia and HTLV is a counter pathogen for AIDS, this could explain why the AIDS epidemic exploded like it did. In a remote African village, the occasional transmission of HIV without its partner HTLV to an individual might result in that individualâ€™s early death but it would not adversely affect the local population if that local population was mostly co-infected, and therefore protected from a single virus disease. However, with modern means of mass travel allowing virtual immediate contact between continents, and with modern mores sanctioning sexual promiscuity, an occasional individual infected with HIV alone, without its partner HTLV, would be capable of setting off a train reaction of mono virus transmission from sexual partner to sexual partner in those parts of the world which have no exposure to the counter pathogen. It would spread like the Black Death of old, which is exactly what seemed to be happening in the last decades of the 20th century.
Once upon a time, it was thought that HTLV was the cause of AIDS (Note 3). At that time I was suggesting the opposite. I was proposing that HTLV might be a cure rather than a complication. Today there is circumstantial evidence (Note 4) that this might be true but it is by no means definitive. So what do I do about my long lost cure for AIDS? Do I forget about it again? Do I wait for a vaccine to come along which renders it redundant? The problem with a vaccine is that it prevents people from contracting AIDS, but it canâ€™t help those whoâ€™ve got AIDS now and are dying from it. Do I forget about it because there are antiviral drugs which can treat it? The problem about anti-viral drugs is that they can only treat AIDS patients who can get (and pay for) their drugs! It canâ€™t help those who are dying because they canâ€™t get them, and this is especially true in the Third World where access to anti-viral therapy is patchy and compliance even patchier. If an inoculation of a counter pathogen (HTLV) can save the lives of those who are dying from HIV, it is as lifesaving today as it was twenty five years ago. So how do I get anybody to hear about it or do anything about it? This article is my answer. It is an on-line scream for help. It is my way of waving my arms in desperation, my means for attracting attention. I might be wrong; I probably am; and, if I am, so be it. But if thereâ€™s anyone out there who is listening, itâ€™s you Iâ€™m addressing. Who are you? You are anyone involved in AIDS research; you are anyone battling the curse of AIDS in Africa; you are anyone capable of contributing to solving a simple question: Is it possible that HTLV could be used as a cure for AIDS?
Note 1: If anti-viral therapy is begun during pregnancy it can prevent the baby from being infected with HIV, and if anti-viral therapy is begun in the earliest stages of HIV infection it can reduce the HIV reservoir to the point of being a cure (though this is still questionable). Anti-viral therapy cannot cure anyone of an established HIV infection.
Note 2: The Origins of AIDS. Jacques Pepin. Cambridge University Press 2011 ISBN: 9780521186377. The early speculation that HIV might have arisen in Africa has now been substantiated by this outstanding study.
Note 3: Science Fictions. John Crewdson. Little Brown 2002 ISBN: 0316134767. This book is the definitive account of the scientific chicanery that surrounded the battle between Robert Gallo at the National Cancer Institute (who thought HTLV was the cause of AIDS) and Luc Montagnier at the Pasteur Institute (whose team discovered that HIV was the cause of AIDS). It is a must read for anyone interested in (to quote the author) â€śhow scientists behave when the stakes are highâ€ť.
Note 4: Retroviral Co-infections: HIV and HTLV: Taking Stock of More Than a Quarter Century of Research Beilke MA AIDS Res Hum Retroviruses. 2012 Feb;28(2):139-47
Image Credit: Thinkstock
Robert Silman was born and schooled in England and then attended university in Paris where he obtained a degree in Philosophy (Licence Ă¨s Lettres) at the Sorbonne as a student of Jean-Francois Lyotard and Jacques Derrida. He returned to London and obtained a First Class Honours degree in Biochemistry (BSc) as a student of Prof. Lewis Wolpert and went on to qualify as a Doctor of Medicine (MB BS) at the Middlesex Hospital. He practiced as a hospital doctor for a year followed by full time medical research in the laboratory of Profs. John Landon and Tim Chard at St Bartholomewâ€™s Hospital. He gained a Ph.D. for his research and has authored scores of research publications in the major scientific research journals, principally on the role of the pituitary hormones ACTH and endorphin in pregnancy and parturition, and the pineal hormone melatonin in growth and puberty. In addition to his scientific research publications he has also published articles on the social and ethical issues of medicine, and a political thriller, July 14 Assassination under the pseudonym Ben Abro (originally published in 1963 by Jonathan Cape in the UK and William Morrow in the US, republished in April 2001 by the University of Nebraska Press).
Using role play with the medical students led him to an association with RADA (Royal Academy of Dramatic Art) and post-retirement to becoming a theatre producer. As well as producing in the West End of London (Theatre Royal Haymarket), Off-West End (Bush Theatre), the Edinburgh Festival, and at the principal regional theatres of England Wales and Ireland, he has also produced in the USA at the Steppenwolf Theatre in Chicago, and at the Beckett Theatre in New York. Recently he has addressed the problem of how to filter for quality on the web, in particular how to promote artists of talent amidst the immensity of the web. He argued that the great scientific journals had a similar problem about filtering for quality when inundated with quantity. They solved their problem by using the scientists they publish as the filter for reviewing the scientists who want to be published. He decided that this sort of peer review process could be adapted even more successfully to the web, and has been involved in the creation of Wonderland, a website which filters the web for quality and culture, thereby offering to online filmmakers of talent a portal for promotion, and to the public a portal for discovering online filmmakers of talent. Wonderland is the first ever meritocracy on the web and is a member of the IFTC (International Council for Film Television and Audio Visual Communication) at UNESCO. He has had two patents granted by the US Patent and Trademark Office: 1) Quality Filter for the Internet Granted 22 Feb 2011 United States Patent No: US 7895202 B2; and 2) Rewards for Unseen Website Activity Granted: 13 November 2012 United States Patent No: US 8311881 B2
For 20 years he presided, with Jean-Claude CarriĂ¨re, the Rencontres Internationales de lâ€™Audiovisuel Scientifique, an annual month long festival in Paris honoring media contributions to the arts and sciences.
For a detailed list of Robert Silman’s publications, go to: http://www.tambar.co.uk/publications.html