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Functional Cure

Monday, March 18, 2013

The buzzword in the HIV/AIDS community these days is “functional cure.” It’s based on two studies in which some people who have been treated early in their HIV infection with anti-retroviral drugs are able to keep the infection at bay long after (and possibly permanently) they stop treatment. The goal had previously been a “sterilizing cure” in which the treatment completely eradicates every HIV virus from a human body. From the perspective of a patient, it seems that a functional cure means no symptoms or disease progression, continual suppression of the virus by the body, and the potential for it to reactivate in the future. But it also means not being sick for the present and an undetermined amount of time in the future.

It has me thinking about a lot of the Lyme Disease treatments that claim to cure people, especially the ones that generate and leave behind a high load of dormant cells, or cysts. This is true of most antibiotic treatments, herbal treatments, and I suspect heat treatments. Chemicals and heat both cause any Lyme bacteria that don’t die to become dormant. While the infection is dormant, it allows the person to rebuild their body from the ravages of the disease. But it seems like a time-bomb waiting to go off in the future as the result of a major stressor (anything from a car accident to a divorce or death of a loved one to a bad bout of food poisoning to a chemical exposure). Still in the time between when a functional cure is achieved and the infection reasserts itself, the person can have a life again.

In fact, I think functional cure seems strikingly similar to “remission” in the case of cancer. There is no way to be sure the cancer is gone forever or that every cancer cell has been wiped out. But for some amount of time, the cancer has been killed off in a high enough quantity that a person’s immune system can keep it suppressed.

When I started coiling, I wanted to believe that if coiling works at all, it will lead to a sterilizing cure. That after enough Lyme flares, there would be no cysts left and I would be free of Lyme forever…and the same would be true of the other infections. Now I’m not so sure. I think the coil machine does kill the bacteria, for sure, and it does so without triggering cyst formation in the bacteria that don’t die. But the question of whether it can get every last cell still tugs at me.

What I’ve come to understand is that as my immune system gets stronger, it will have the power to do some of the fighting against these infections. My body’s immune response may force some of the Lyme bacteria into cyst form. This doesn’t take away my belief that the coil machine is the right way for me to battle Lyme disease. Instead, I see it as better than antibiotics because when the infection finally gets suppressed, I will carry a much lower load of dormant Lyme, giving my body a better chance at keeping it suppressed forever.

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