WHEN presenting his work at the global gene-editing summit, He Jiankui noted the medical seriousness of HIV infection, saying he was proud of his efforts to use CRISPR to create infants that may be resistant to the virus.
Is HIV so dangerous that it warrants such a drastic step? Certainly, the toll of HIV infection is high in some parts of the world. But advances in antiviral medicines over the past decade mean that people with HIV who have access to good healthcare now have a close-to-normal lifespan. The HIV-positive fathers who took part in the trial are reported to have had their virus under control, suggesting these men had access to such drugs.
Advertisement
Gene editing doesn鈥檛 offer HIV-positive men their only chance to have unaffected children. Current treatments for HIV push the level of the virus down so low that a person鈥檚 partner or future offspring aren鈥檛 at risk of infection. Furthermore, the experiment used a 鈥渨ashing鈥� technique to remove any HIV from the sperm before it was used for IVF, meaning that even without drug treatment, no virus could have made it into the embryos.
If the aim was to protect the children from acquiring HIV as adults, a much simpler and safer medical intervention is already available to some: taking some of the antivirals used for treatment as a preventative. In certain Western cities, this 鈥淧rEP鈥� strategy is contributing to tumbling rates of infection among gay men.
鈥淭he choice of gene was about the stigma that surrounds HIV rather than fulfilling a medical need鈥�
It can be argued it would be easier not to have to take such medicines. If we reach a stage where editing embryos becomes routine, could the modifications made by He be worth including? It seems unlikely, because mutating the CCR5 gene as he did doesn鈥檛 give complete protection against all strains of HIV. People would still need to take preventative steps such as using condoms or PrEP.
He鈥檚 choice of gene was all about the stigma that still surrounds HIV rather than fulfilling any real medical need, says Deborah Gold of the UK鈥檚 National AIDS Trust.
This article appeared in print under the headline 鈥淲hy was HIV the first target of gene editing?鈥�
