HIV, read in the Eighties as an immediate sentence to a lingering death, has now been controlled to the extent that a living HIV-positive woman has donated a kidney to an HIV-positive recipient. Living-to-living donation is commonplace among people without serious conditions, but was hitherto unknown in the HIV-positive community, where even the possibility of receiving a kidney is limited by the condition that the patient must have a zero viral load. Besides, there were concerns that HIV or antiretroviral treatment for it would compromise the donor’s surviving kidney. But now, Dorry Segev of the Johns Hopkins University School of Medicine has helped 35-year-old Nina Martinez, a public health consultant, to give her kidney to an unnamed HIV-positive recipient. This is a milestone, indicating that HIV-positive people are now at no more risk than others.
Earlier this month, a report on the iEngage trial for viral load reduction was presented at the Conference on Retroviruses and Opportunistic Infections in Seattle. Subjects of the study, under a new regimen of therapy, had achieved full suppression in 63 days, and 83 per cent had not back-slided after the study concluded. The result suggests that it is possible for the majority of HIV-infected people to lead normal lives, without suffering the cataclysmic health effects of immune deficiency, and without running the risk of transmitting the virus to others.
Back in the Eighties and Nineties, the global battle against HIV/AIDS had sought to eliminate transmission and disrupt the life cycle of the virus. Later, it sought the less formidable target of letting people live full lives with the infection. With the transplant at Johns Hopkins, the achievement of this goal has been demonstrated. And it is also clear that despite stringent transplant rules, no HIV-positive patient needs to die for want of an organ.