What does HIV mean?

It's a strange question, I know. But it makes me wonder these days. It remains a very real life-threatening virus, but more and more - it seems like it is being treated as a nuisance. Instead of being a virus associated with certain death as it once was, it is now something to be controlled, much like diabetes, or perhaps more appropriately, like herpes. By adhering to a medication regime, most people can maintain relatively healthy immune systems indefinitly.

So what does this mean to a person afflicted with the virus? I think back to when herpes was the dread sexually transmitted disease - the stigma associated with it, the embarassment that people suffered. HIV infection is very much like that now, except there is a more tangible fear of mortality. We have to bear in mind that when the virus and the illness linked with it that became defined as AIDS, it meant an often painful death. The images that we were exposed to some 25 odd years ago of KS, wasting frail men and women... remain with us. Even today, we are presented with images of people in third world countries without access to anti-viral medications and we see them enduring the same pain and misery that represented the early days of AIDS in this country. All that keeps the majority of people afflicted with advanced HIV infection, is a number of pills that must be taken daily.

Earlier today, I posted a link to a document regarding a gene therapy designed to alter the immune system to keep the HIV infection in check. It isn't a cure. It is providing the immune system a way to avoid advancing infection with an enhanced HIV resistent CD4 cell line. If this therapy proves to be successful, what will HIV mean then? Should we imagine that one day - you will go to the doctor, who informs you, "You have an active HIV infection. We need to make an appointment to have some of your immune system cells harvested so we can give you an improved immune system. We will need to monitor you and your immune system, but you shouldn't need to take any medications for this."

This is a very real possibility. Currently, clinical trials are detirmining if this therapy is enough to maintain an immune system without the need for anti-retroviral medications. What will HIV mean then? I would think that people would want to continue to avoid infection, but if the only consequence is a medical procedure (probably more than a little expense involved) will anybody really worry about it the way we do today?

I hope not. I hope for the day when HIV, if not simply cured, will be just another thing to deal with - then be forgotten. "Oh, I have HIV, but I also have a new and improved immune system, so I don't think about it too much." Or better still, "I don't have HIV, but I went ahead and had gene therapy so if I am exposed it won't end up being a problem."

What do you think?