Why don't leave HIV infected people in aseptic environment until they're cured?
Sorry if the question is silly, but this is something that has been around my head for years:
As far as I know, the HIVirus feeds itself out of the inmune cells (from Wikipedia, emphasis mine):
HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4+ T cells through a number of mechanisms, including pyroptosis of abortively infected T cells, apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.
So, I thought that HIV victims die out of diseases that they will survive if they weren't infected by HIV. In other words: HIV destroys the immune system and then the person dies because of a different cause.
If this is true, why isn't posible to keep HIV infected people in aseptic environments waiting for the virus to consume all the immune cells and "die out of starvation"?
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There are three major reasons why we can't just keep someone in an aseptic environment and wait for their CD4 count to drop to zero and - presumably - for HIV to have consumed itself to extinction in the patient:
Time. In the Pre-HAART era in a middle-income country like Brazil, the median survival time for someone with AIDS was 1.1 years, but that can be a very long tailed distribution. That's extremely expensive, and the logistical capacity to keep someone in perfect isolation and containment for that period of time doesn't really exist on a population scale. And keep in mind you'd have to be perfect that entire time, with no room for errors of any sort, as you're essentially allowing people to become extremely immune compromised. That's not at all practical, even on a theoretical level.
Native flora, cancers, etc. An HIV+ individual still has their own native flora, which may become dangerous due to a compromised immune system, such as C. difficile. They may have been previously infected by a dormant herpes virus. And they're at higher risk of cancers, only some of which are infectious in origin and thus could be prevented in a perfectly sterile environment.
HAART. HAART therapy is awesome, and while not a cure for HIV/AIDS, is an extremely effective treatment for the disease. Any amount of money used keeping people in perfectly sterile isolation for years on end is likely better spent increasing screening and access to HAART.
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