Submitted by robotisland t3_105aeln in askscience
provocative_bear t1_j3ak0un wrote
Leishmaniasis (called L- from here on out) prevalence largely depends on the prevalence of the sand flies that spread it. While technically it can be spread sexually [1], people with visceral L- are not generally in a condition to be having sex. Therefore, it doesn't spread too well as an STD. Meanwhile, HIV is an insidious disease where the host can survive for years and be active for much of it before succumbing. Additionally, there are often visible signs of L- sores and lesions- while HIV patients show no outward signs of the disease. In short, L- patients are generally clearly sick to both host and partners, while HIV patients are not.
In terms of treatment, you can wipe it out L- with antiparasitics. Treatment is unpleasant, but it is curable. In contrast, HIV is a very sneaky disease. It is a retrovirus, meaning that it can jam its genetic material into your cells' DNA and hide in that form. Even if every virus in the human body is wiped out, the HIV DNA in the host cells can activate, and then the patient is infected all over again. That's why HIV treatments are the way they are, where a patient can be basically normal, but not cured.
CopremesisWaterfall t1_j3bmj8l wrote
Awesome reply, thank you!
BigCommieMachine t1_j3gy0y6 wrote
Could you hypothetically engineer a virus that just injects the undamaged/unaltered DNA of a person back into infected cells?
I mean if if a harmful virus can inject itself in your cells DNA, could we just create virus with “normal” DNA that just boots it out? I mean this could even apply to other genetic diseases. Put a person on massive amounts of immunosuppressants and let the “helpful” virus go to town.
provocative_bear t1_j3jfchy wrote
We have only recently figured out safe viral gene therapies (usually called lentiviral therapies)- the FDA approved the first two of them in 2022 [1]. I agree that to actually cure HIV, we'd need a system that can hunt down and correct the rogue DNA in our cells, but the technology is not yet there. First of all, to my knowledge, current lentiviral therapies aren't very good at targeting where in the genome they insert. That would be important to correct the implanted HIV sequence. However, our CRISPR DNA engineering systems are good at this. Understandably, there is work underway to combine the two [2], but academia tends to lead actual therapies by quite a bit. In the cases of both potential therapies, they wouldn't come close to screening / inserting into every potentially infected cell with our current technology. There's a lot of interest in improving this issue in pharma, though. Maybe it'll be possible some day, but not before a lot of work in the field.
I think about this specific question in the shower a lot, and am kind of stoked that somebody asked it.
[1]: https://asgct.org/publications/news/september-2022/eli-cel-second-lentiviral-vector-gene-therapy
[deleted] t1_j3jq1yy wrote
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MaximoEstrellado t1_j3dfoz3 wrote
Lovely and succinct answer. Thanks.
robotisland OP t1_j3fun84 wrote
Great explanation! Thanks!
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