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With news coming out every day about 'functional cure' of HIV (see http://www.cnn.com/2013/03/18/health/hiv-functional-cure/ for example)- I was wondering if anyone in the community has been approached by patients interested in finding out if they are functionally cured. Has anyone encountered this? Obviously, my concern is around people stopping ART without coordinating with their care provider and then have viral rebound and wait too long to decide to come back into care.
Rivet

 
Byaruhanga B Emmanuel
Replied at 6:29 AM, 19 Mar 2013

Thanks Rivet,

Based here in Rural Uganda, I am actively engaged in HIV/AIDS Research
where adherence monitoring, reproductive health issues among HIV/AIDS
patients and Discordance to mention but a few, form a greater part of our
daily research work.
Unfortunately, it is just a handful of the study team members who have
discussed it though not a lot. And surprisingly, there has been no much
discussion about that, neither has it been welcomed with any form of
excitement among the research participants. While discussing the
'Functional Cure of HIV' phenomenon, there were mixed feelings about people
wanting to excite the world by accessing the press. One participant is
reported to have said that the Mississippi Child was born HIV-Negative.

Emma

SHAZIA ABBAS
Replied at 1:43 AM, 20 Mar 2013

I think; it is still too early and results should be interpreted cautiously.... although similar results are also shown in adults by French researches - calling it "Post Treatment HIV controllers" or "in long term remission." The idea is starting of treatment asap after the exposure.
Although promising for children; for adults it will open another avenue as in most of the cases; the disease has a silent path and remains unknown for many years before diagnosis

Attached resource:

Pamela Marks
Replied at 10:29 AM, 20 Mar 2013

Here also is the study attached which refrences the long term controllers- Visocnti Trial.

Attached resource:

K. Rivet Amico, PhD
Replied at 5:32 AM, 28 Mar 2013

Thanks so much for the added insights on this issue.
Rivet

Rob Camp
Replied at 7:12 AM, 29 Mar 2013

It may happen that someone who started treatment early and has been on therapy for a number of years now is interested in talking with their doc about stopping, but it so unclear - the factors that go into 'who' it would work for and under what conditions. Remember, Visconti is 14 people out of some unclear denominator and the factors (if any) that all of them share beyond having started early are not enumerated!

Also, I think most people who have started early (how many is that, anyway? a handful of the 8 million people on treatment!) - less than 6, 3, 2 months? - once their HIV is undetectable etc would actually be wary of stopping, I bet.

People in care on tx are generally not going to simply stop it AND stop seeing their doc! It's almost amusing, the premise. The whole discussion is a red herring. It isn't logical!

Again, sure, a person here or there, but any person who is an early treater probably has a really respectful relationship with his/her tx and his/her doc and isn't gonna start walking a tightrope because of CNN! Thx. : - )

K. Rivet Amico, PhD
Replied at 4:54 AM, 30 Mar 2013

I really hope you are right about people working closely with their provider and weighing the evidence. However, logic does not always drive behavior...actually- not true- most people have perfectly sound logic from their perspective driving a course of action but it just is not necessarily "our logic." Your point about strong relationships with providers is key. Open discourse on treatment plans and concerns is probably the very best course of action for helping people to make sense of information presented (sensationalized) on TV and internet.
Again- thanks to everyone for comments about this!
Rivet

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