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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"?

  • HIV won't starve due to lack of bacteria. HIV survives by invading the body's white cells and hijacking the cell's machinery to reproduce. Eliminating all bacteria won't eliminate white cells, and therefore it will accomplish nothing except probably making the patient very ill when you try to sterilize them by wiping out all their gut flora. – Carey Gregory May 3 '17 at 19:33
  • I got lost in your text, sorry :'( what bacteria are you talking about? – Paula_plus_plus May 4 '17 at 6:58
  • The trillions of them you're carrying around with you in your GI tract and on your skin. – Carey Gregory May 4 '17 at 12:13
  • But those bacteria aren't white cells, I think that I'm misunderstanding something. – Paula_plus_plus May 4 '17 at 12:16
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    I think so too but I don't know what it is. Bottom line is living in an aseptic environment won't cause HIV to die off nor will it get rid of the white cells that host HIV. HIV will be perfectly happy to live, reproduce, and cause AIDS in someone living in a perfectly sterile environment. – Carey Gregory May 4 '17 at 13:16
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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:

  1. 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.
  2. 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.
  3. 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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  • Okay, I'll give you the +1 for a good explanation of why it's not possible. :-) – Carey Gregory May 5 '17 at 3:57

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