Trying to Cure HIV By Studying Nairobi Prostitutes

It turns out a portion of the Nairobi sex trade may hold the answer to curing AIDS. Genetically, these prostitutes have an immunity to AIDS, despite repeated exposure to the disease, making them long term survivors (LTS's). There are roughly 140 of these LTS's out of the roughly 2000 workers in the Nairobi, Kenya sex trade. Though this may sound like a high percentage of LTS's, it does not take into account the large number of women who have died of AIDS from exposure to HIV due to unprotected sex. In reality, the genetic trait that enables long term survival is much more rare.

The future is often found in the past.  A 2003 Time Magazine article discusses a Nairobi prostitute, Agnes Munyiva, who was immune to HIV, despite being repeatedly exposed to it for well over a decade. The article goes on to discuss some work to discover why she was a LTS, though the real reason is still not exactly known, or at least if it is, some scientists are holding it close to their vests. 

See: http://www.time.com/time/magazine/article/0,9171,979763,00.html

Indeed, long before this article, the uniqueness of LTS's in the African sex trade caught the attention of IAVI, the world's foremost organization working on a cure for aids.

See: http://www.thebody.com/content/world/art2763.html

and 

See: http://www.iavi.org/Pages/home.aspx

However, Dr. Francis Plummer and nobel laureate Dr. David Baltimore, among many other researchers, have taken up the challenge of discovering what is unique about these LTS's. So far, there are a number of observations, but nothing definitive. Some evidence points to proteins in the vaginal fluids of the LTS's, while other scientists note there is something unique about the CCR5 on the surface of their T-cells. 

See: http://www.sciencedaily.com/releases/2008/09/080901205622.htm

HIV does its damage by invading the T-cells and CD4 cells of our immune system. There is other evidence of unique traits in these LTS's, as well, but one thing is certain, the reason appears to be genetic. 

Though this approach of analyzing LTS's makes sense and holds promise, there are numerous other approaches to protect against and treat HIV/AIDS, some of which may hold even greater promise - more on those approaches in future submissions to this blog. The one thing each of these approaches have in common is that they may benefit from a derivative of HIV, called a lentiviral vector (LV), which is HIV stripped of its harmful effects, e.g. it cannot replicate or mutate. As discussed in the first entry to this blog, LV is the most efficient way to make many types of vaccines and proteins, and in some cases, it is the most efficient way to transfect, or change, the genetic makeup of a cell population. 

For example, once scientists zero in on exactly what is unique about these LTS's, with existing technology today, they could remove the healthy T-cells of HIV-infected individuals, multiply them 1000 to one million-fold using small particles called "beads", or K562 cells, transfect the cell population with the genetic material using LV to match the LTS's T-cell genetic makeup and reintroduce them into the patients.

This approach is not inexpensive, but it would eliminate the need for anti-retroviral drugs that people infected with AIDS must take every six hours of every day, which damage the liver and around which AIDS has a habit of mutating, requiring new anti-viral drugs. This may be good for the drug companies, but it's suboptimal for people with AIDS. 

Hopefully, scientists will find a treatment that is both prophylactic and therapeutic, perhaps, in part, due to the unique genes of the LTS's among the Nairobi sex trade.