[extropy-chat] magic johnson, aids, longevity ...

[Robert Bradbury]

The thing to remember about viruses is that they are very small and if one
can control their numbers they are not a problem.  So this allows people to
live with diseases like TB or Hepatitis for extended periods.  It helps if
you have access to the technlogy and a physician (so money is a +) which
allows you to stay on the leading edge of understanding the virus and its
therapies.

HIV is a relatively simple virus (only a few genes) and suffers from the
benefit / handicap that its genome copying gene/protein (the reverse
transcriptase) is relatively sloppy (making inaccurate copies).  So this (a)
means that the virus can't be *too* productive since many of the copies it
makes may not work; and (b) the copies it can make will vary enough that
they may develop resistance to the drugs being used to treat the disease.

HIV also infects cells in the body (white blood cells) which are designed to
be able to replace themselves at a relatively high rate.  So if the virus
kills the cells, or the other cells in the immune system kill the cells
containing the virus, they can be replaced (if one knocks the virus down to
low enough levels).

The problems with early HIV treatments is that they used only a single drug
so it was relatively easy for the virus to develop mutants that that drug
was ineffective against.  With the development of the so-called "triple
cocktail" approach three drugs are used which target different
vulnerabilities in the virus reproduction pathways.  So to work around the
drugs the virus has to develop three mutations which becomes much more
difficult.  As there are multiple drugs with somewhat different effects and
we have sufficient information now about which mutations are bypassing
specific drugs physicians can monitor how a viral load is mutating and
change drug therapies in response to that.

So I suspect Magic simply has access to physicians and labs on the cutting
edge of the knowledge curve and might be able to gain access to the newest
drugs sooner than knowledge about them is made generally available.  I
worked in the HIV lab at the Univ. of Washington for a summer in the early
'90s - this is a *very* specialized branch of medicine and to get the best
quality care you need to get physicians who go to the HIV conferences, have
access to the best lab facilities, know what drugs are being developed, are
aware of how the virus is evolving (from the perspective of individual
patients as well as in cities, countries & world regions), etc..
Fortunately many patients have the self-interest to learn all that they can
about the disease (and even go read the journal articles if they have the
interest) -- PubMed is a significant public resource now (as are Wikipedia,
many open access journals and the non-physician AIDS therapeutic networks).

There is also hope on the horizon that a couple of more targets may develop
for the virus (so a triple cocktail may turn into a quintuple cocktail).

Some simple questions for your physician:
a) Do they know how they will change your drug therapy in response to the
development of resistance by the virus?  (I.e. if the viral load
increases.).
b) Do they know what mutations make the virus resistant to the drugs you are
currently taking?  (Specific mutations in specific genes lead to resistance
to specific drugs.)
c) Have they sequenced (or when do they plan to sequence) your current
virus?

Most physicians operate at the level of (a) and the general response is that
if the standard drugs aren't working to change the recipe.  The people who
really know what they are doing know which mutations cause the drugs to lose
efficacy (b) and know whether or not *you* have them (c).

Right now there is no "cure" for HIV (in fact this is probably true for many
viruses) -- there a continual effort however to keep confining it to ever
smaller boxes (which make it both difficult to transmit and may eventually
give your immune system the upper hand with respect to eliminating the cells
which harbor it).

Eventually there will be nanorobots which will be able to wander through
your body identify HIV viruses which are behaving badly (trying to infect
other cells) and rip them to shreds -- we are still a few decades away from
that however.

Robert

P.S. If you do not have a strong medical background I would strongly urge
you spend some time with Wikipedia, a medical dictionary for terms not in
Wikipedia and then perhaps HIV review articles from PubMed (go to PubMed and
query on "HIV AND review").  I believe that approach will rapidly get you up
to speed.
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