Real Life Frequently Asked Questions

World AIDS Day and the Link&Think project seems like as good a time as any for me to look back over four years working on the molecular biology of HIV-1. I’ll start with some of the questions people asked me when they learned that I was working on HIV.

1. The question of whether AIDS is caused by HIV-1 has been laid to rest and the answer is yes. Look here for detailed info.

2. No, you can’t get it from a toilet seat (or a telephone; you’d be amazed at the number of people who, having dialed the HIV-1 laboratory by mistake, couldn’t put the phone down fast enough!). You can only be infected by HIV-1 through contact between your bloodstream and the virus laden bodily fluids (most importantly blood, semen and anal and vaginal secretions) of an infected person. It’s quite a labile virus, and does not survive long outside the protective environment of the host body. If this is a relief to you, please keep linking and thinking until you know how to protect yourself against AIDS! Here are a couple of links (AIDS basics, whatudo) to get you started.

3. What is HIV-1, anyway? Physically, it’s a roughly spherical particle about 100 nm across. That’s 100 thousand millionths of a meter; for comparison, the diameter of a human hair is about 50 millionths of a meter, 2000 times larger. For a rough visualization, think of an orange studded with cloves, not so closely that they touch but nearly so. Biochemically, it’s an outer lipoprotein coat and an inner nucleoprotein core. Genetically, it’s an RNA genome which is converted to DNA and inserted into the host cell genome in the process of infection, and then expressed in a manner similar to cellular gene expression. Viral RNA and proteins assemble at the cell membrane and form immature virions which bud off from the membrane and, after maturation, can continue the cycle. If you want to go into the natural history of HIV-1 further, the HIV InSite Gateway and the online textbook Retroviruses are good places to start.

4. There’s no cure yet, and I think a vaccine is still some way off (if pressed, I’d say I wouldn’t be surprised to see a vaccine in my lifetime, but it’s virtually impossible to be more precise). That’s the bad news; the good news is that vaccine trials are proceeding, drug discovery continues, and basic research is ongoing. I firmly believe that research will beat HIV.

It’s VERY important to note at this point that infection with HIV-1 is still a death sentence. There is no cure, and if you get infected now there is not likely to be any advance in what’s left of your lifetime to save you. There has been an upswing in the rate of new infections in western countries, at least in part because of the erroneous impression that “new AIDS treatments” will effectively give you back your life. No, they won’t. You may live quite a long time, but it will not be all beer and skittles: antiretrovirals are vile drugs and can make you sick and miserable much of the time. To illustrate this: some portion of the failure of combinatorial chemotherapy against HIV-1 can be traced back to patient noncompliance with the drug regime, because it is so unpleasant. Recent innovations include trialling “drug holidays”, brief pauses in the usual drug regime designed to protect against such noncompliance.

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