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For AIDS, 'Cure' Is Still a Four-Letter Word
November 13, 2008 4:23 PM
By Dan Childs, ABC News Medical Unit
It’s a line that I must have heard in no fewer than a dozen journalism classes -- probably something having to do with headline writing or news placement:
“… So say, for example, that they invent a cure for AIDS.”
For the professor, the idea was to come up with a hypothetical situation that was so earth-shattering that it could be used to illustrate a teaching point -- and at the same time so unlikely and fantastic that we students would not get distracted by pondering the likelihood of whether such a thing could actually come to pass.
The teaching point is this: There are some stories that, when they break, must be given prime placement. They must be shouted to the world.
So when the news rolled across the wires that German doctors report removing all traces of HIV from an American man’s body, perhaps it was little surprise that these headlines followed close behind:
-- AIDS Cured Via Bone Marrow Transplant
-- Patient Gets Accidental AIDS Cure
-- AIDS Cure Found
-- Bone Marrow Transplant Cures Man of HIV Virus
-- German Doc Miraculously Cures AIDS Patient
The list goes on. The reports that carry these headlines come from around the world, from New Zealand to Massachusetts.
But what they all have in common is medical journalism’s most infamous four-letter word -- cure.
Is it a problem in this case? Let’s take a look at the facts. The patient is a 42-year-old man who had been HIV positive for the past decade. He also had leukemia.
Doctors at the Berlin Charite hospital’s Clinic for Gastroenterology, Infections and Rheumatology hoped to treat the man’s leukemia through a bone marrow transplant, in which the patient’s entire immune system is killed off and replaced through an infusion of bone marrow from a donor. In this case, the doctors found a bone marrow donor who also had a rare genetic mutation that made the donor resistant to HIV infection. The procedure got rid of the leukemia. But doctors were also startled to find as well that no traces of HIV remained in the man’s system.
If you are a big fan of happy endings, feel free to stop reading this blog here. Heck, you can call this episode a medical miracle and feel delighted for the unnamed patient, who’s most likely on cloud nine himself at this point.
For those of you who want to stick around, here’s the other side of the coin.
Attempts to treat AIDS using bone marrow transplants are not new; in fact, they have been tried many times -- as early as 1982 and as recently as last year -- usually with little success.
Today, there are perhaps three or so cases in which a bone marrow transplant appears to have sent the disease into remission -- which means that either: 1) The virus is completely gone; or 2) It is still present, but in levels too low to be detected by current means. The safer bet is the latter.
Why might this be? And what happened to the several dozen others who got new bone marrow, but died anyway?
For one thing, AIDS researchers say the changes that the virus makes to the DNA once it’s in the body are not wiped out with the immune system. Thus, when the immune system “reboots,” the HIV signature remains and the whole infection process restarts.
The other thing to remember is that, today, millions of people infected with HIV are on a steady cocktail of anti-retroviral drugs that keep the virus at bay. In many of these people, levels of the virus are also undetectable. Provided they keep taking their medicine, many can remain alive in this state for decades. Does this mean that they are “cured”? Far from it. Take the drugs away, and HIV will emerge from its reservoirs in the body and begin its rampage on the immune system once more.
On our site, we ran the Associated Press story with the headline: “Cure for AIDS, or Lucky Fluke?” The answer, of course, was implicit. But perhaps it would have been better if we had left that infamous four-letter word out altogether.
Cases like this most recent one in Berlin give us real hope for new directions in treatment. But if hope for a cure, when teased apart, is found to be false, it can have an undermining effect on positive findings. For a disease for which good news is already in short supply, some hope can easily turn into no hope, and we find ourselves faced once again with the specter of a horrific and seemingly invincible disease.
Sure, call us skeptical. We’ll continue to man the battlements, looking for the next shred of hope against this killer.
Meanwhile, journalism professors the world over can rest assured that the sanctity of their hypothetical headline remains intact, for now.
November 13, 2008 | Permalink | User Comments (9)
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"...the doctors found a bone marrow donor who also had a rare genetic mutation that made the donor resistant to HIV infection." This is the part of the story that I find most interesting, I had no idea that someone could be resistand to HIV...could there be a cure in that mutation?
Posted by: samhiguchi | Nov 13, 2008 4:58:46 PM
All those who are familiar with Healthcare and comprehend the vicious cycle know full well that 'CURE' is a four letter word for the makers of drugs and those who siphon off the billions of tax dollars in the name of
R & D.
"Absolutely ludicrous to think there will be any cures" as I tell many who suffer from ailments. No cures, just controls is the name of the game that will keep patients in the revolving door. Its the best moneymaker.
After mortgages, Autos and Financial Institutions, the meltdown is coming to the Healthcare Industry, much of it run by the Insurance Industries and the attorneys.
Better take a lesson and remove the sacred cows of Govt. Insurance namely Medicare and Medicaid as well as Private Insurance. Just remove it all and let each doctor and insurer as well as malpractrice litigator sink or swim in a free market economy.
Bet you all the cut throat doctors will castrate each other and bring the price of this trillions of dollars down to a sensible state.
Thank you.
Posted by: Yamin Farhat | Nov 14, 2008 2:51:21 AM
Dan, I don't know if I was that professor you were referring to, but I'm very hesitant to put "cure" and "HIV' in the same sentence, let alone the same headline. As you say, you don't want to turn "some hope" into "no hope." Advances in HIV treatment have prolonged the lives of millions of people, and I do hope a cure is found some day. But we're not there yet so I'll support you in your skeptical and restrained reporting.
Posted by: Tom Linden | Nov 16, 2008 9:16:56 PM
Interesting you should mention it, Dr. Linden... While tapping this out, I actually had in mind an article you presented in class penned by another esteemed medical journalism prof, Gary Schwitzer, titled "The Seven Words You Shouldn't Use in Medical News." For those who have never read it, here's a link:
http://www.tc.umn.edu/~schwitz/The7words.htm
Good advice, and it sets a very high bar.
Posted by: Dan Childs | Nov 17, 2008 9:46:50 AM
Doctors in America don't want "cures" for anything! Healthy patients spells "no money" for the medical field. Notice all the great innovations in medicine come from over seas.... American medical professionals can't make boat payments and country club memberships if they don't have sick patients. They should all be ASHAMED!
Posted by: Mudbone | Nov 23, 2008 4:09:07 PM
On this 20th anniversary of World AIDS Day, I see there have been many advances in the fight against AIDS and many more let downs. As a person living with HIV/AIDS for over 22 years, it has come down to deciding which in the long run would be better; continue to fight or die. Unfortunately, the choice is not mine to make. It is the choice of the drug companies. I can no longer afford to take medications that have cost me over $700.00 per month. It all boils down to quality of life over quantity. I have given up a lot of dreams just to pay for my drugs and I live day to day wondering when they will fail and get sick to the point of no return. So I've given up. The drug companies will no longer gain from me and I can now start living to die instead of living to live.
It's really a shame that I have to be forced to make the decision. Thank you drug companies.
Posted by: Eddie | Dec 1, 2008 9:59:06 AM
samhiguchi - There are rare instances of immunity. The people so far have been of western European decent. They believe that the Black Plague of the 1600s caused a genetic marker to occer. If a person gets 2 of these markers in their DNA, they are immune.
Posted by: Huh | Dec 2, 2008 8:11:41 PM
I think a cure is always a possibility. It's just hard when people laugh at the disease. See this quip from Family Guy for instance:
Posted by: Coot | Dec 6, 2008 10:16:40 PM
Its true that people rather make money off sick people then to help cure them. I dont have aids nor do any of my family members and i dont know anyone that has it, but for many years now i have had a dream almost every night. In this dream im sitting on a cloud in space looking at the earth in front of me and then i look behind me and i see the gates to heven, then i look to my right and i see jesue eatting an apple, he speaks and tells me its not my time. I say well when is my time. He says i cant tell you that, i ask him well what can you tell me. He reply's "I can tell you what the cure for aids is", then he opens his other hand and i see a frog. Then i wake up wounding is this true or m i going crazy. I dont understand this dream maybe some one could tell me what this means. Its been 8 years now and i still dont know what it means. Please email me what u think this dream means.
my email is blackdragon2728@yahoo.com
Posted by: Crhis | Mar 28, 2009 4:17:25 PM
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