‘Cured,’ by Nathalia Holt
Patients and Fortitude
By GEORGE JOHNSON, NYT
MAY 9, 2014
For the deadliest medical conditions, “cure” is a word even the most optimistic doctors try to resist. Oncologists have seen too often how a few metastatic cancer cells can endure every poison medicine throws at them, chemical or radioactive, only to lurk silently for years before staging a triumphant return. No wonder pharmaceutical companies prefer to describe their state-of-the-art cancer drugs in terms of five-year survival rates, with no promises about what happens in Year 6.
Since it appeared more than 30 years ago, AIDS has been at least as resistant to decisive victories. Doctors have succeeded in holding the disease in check, turning a once fatal illness into a chronic one. But the virus, H.I.V., remains in the body as a steady influx of antiviral drugs keeps it from carrying out its program of immunological destruction. Take away the medicine and the disease threatens to reappear.
There have been some tantalizing exceptions. In “Cured: How the Berlin Patients Defeated HIV and Forever Changed Medical Science,” Nathalia Holt describes the two most famous cases and what they might mean for the future of the disease. In neither man was the virus exterminated. But years after stopping treatment, they have shown no new symptoms. They have achieved, so far, what doctors call a “functional cure.”
It is risky using the c-word in the title of a book about AIDS. But Holt, an H.I.V. researcher in Boston, is aware of the perils. As she makes evident, the two cases are extraordinary, difficult to interpret, and have yet to result in mainstream treatments. But the Berlin patients may serve as what mathematicians call an existence proof — a demonstration that something is possible, even if it is not clear just how it is to be done.
(More here.)
By GEORGE JOHNSON, NYT
MAY 9, 2014
For the deadliest medical conditions, “cure” is a word even the most optimistic doctors try to resist. Oncologists have seen too often how a few metastatic cancer cells can endure every poison medicine throws at them, chemical or radioactive, only to lurk silently for years before staging a triumphant return. No wonder pharmaceutical companies prefer to describe their state-of-the-art cancer drugs in terms of five-year survival rates, with no promises about what happens in Year 6.
Since it appeared more than 30 years ago, AIDS has been at least as resistant to decisive victories. Doctors have succeeded in holding the disease in check, turning a once fatal illness into a chronic one. But the virus, H.I.V., remains in the body as a steady influx of antiviral drugs keeps it from carrying out its program of immunological destruction. Take away the medicine and the disease threatens to reappear.
There have been some tantalizing exceptions. In “Cured: How the Berlin Patients Defeated HIV and Forever Changed Medical Science,” Nathalia Holt describes the two most famous cases and what they might mean for the future of the disease. In neither man was the virus exterminated. But years after stopping treatment, they have shown no new symptoms. They have achieved, so far, what doctors call a “functional cure.”
It is risky using the c-word in the title of a book about AIDS. But Holt, an H.I.V. researcher in Boston, is aware of the perils. As she makes evident, the two cases are extraordinary, difficult to interpret, and have yet to result in mainstream treatments. But the Berlin patients may serve as what mathematicians call an existence proof — a demonstration that something is possible, even if it is not clear just how it is to be done.
(More here.)
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