Four things you should know about the HIV "cure" before you get too excited

The baby might not even have been infected in the first place.

The story everyone is talking about today is the HIV "cure" - the Mississippi baby who, after being blasted with a cocktail of anti-viral drugs at birth, is now, at two years old, apparently virus-free. But when reading the euphoric news stories about it here, here and here, you should bear the following in mind:

1. The baby may not even have been infected in the first place

Here's a weird section in the NYT version of the story. Have a read of the following two paragraphs - are the doctors certain or uncertain that the baby was infected?

“The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital in Boston.

Dr. Persaud and some other outside scientists said they were certain the baby — whose name and gender were not disclosed — had been infected. There were five positive tests in the baby’s first month of life — four for viral RNA and one for DNA. And once the treatment started, the virus levels in the baby’s blood declined in the pattern characteristic of infected patients.

The tests are pretty good, but are not usually trusted as a basis for confirmed diagnosis at that early stage. It is normal practice to confirm positive tests at 6 weeks. But as this baby had already been treated by then, lowering its viral load (negative tests came back at 29 days), it would have been difficult to do this. There is a very small chance the baby was not infected.

The virus may not have yet taken a hold on the baby's cells in a permanent way. Here's the WSJ:

Cells in the baby "may have been infected—there was virus around," said Steven Deeks, an AIDS researcher at University of California at San Francisco. "But the cells being infected weren't the type that become long-lived reservoirs."

There is also a small chance the baby was immune to HIV anyway. Around 1 per cent of Caucasians in the US are naturally immune.

Now, these are small chances, but then this baby is an outlier. It was not part of a large study where such anomalies are ruled out. The scientists have said it is unlikely to be replicable. Any way you put it, the baby itself is an anomaly.

2. This "cure" has already been found, and has been used on newly-infected people since 1987. Even if the baby was infected, today's news would simply extend it to newborns.

Today's news applies only to babies. Newborns at that. And it's not really a new method - rather, it's the same idea as PEP: if you have only just been infected, you might avoid HIV if you are immediately given a large amount of anti-HIV drugs. What the scientists confirmed today is that, in terms of emergency treatment, newborns are the same as newly-infected people. 

Here's the NYT again:

“That goes along with the concept that, if you treat before the virus has had an opportunity to establish a large reservoir and before it can destroy the immune system, there’s a chance you can withdraw therapy and have no virus,” said Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases.

(Oh, and if you were wondering, someone has actually been cured of AIDs before. This was a man called Timothy Brown, a leukemia sufferer who received a bone-marrow transplant from a donor genetically resistant to HIV.)

3. This would not be breaking much ground in preventing HIV in newborns anyway, because we have a solution for that

In countries with access to top-notch medical care (ie western countries), the transference of HIV from mother to child is extremely rare. This is because mothers are treated with antiretroviral therapy during pregnancy - a very effective way of preventing HIV in newborns.

4. Newborns in countries without a solution for that probably wouldn't get this treatment anyway

In countries without access to top-notch medical care, there is no reason that this treatment would be available where antiretroviral pregnancy treatment isn't.

So what does the news mean? Well it means that a few babies in countries with access to this sort of care but whose mothers have somehow slipped through the net of normal practice can be saved. Joyous news. But not quite as joyous as everyone seems to be making out.

UPDATE: This blog originally said that HIV tests at birth couldn't be accurate, but this applies only to antibody tests. The tests on DNA/RNA, which were done in this case, have a greater (although not 100 per cent) degree of accuracy.

HIV cure: not necessarily.. Photograph: Getty Images

Martha Gill writes the weekly Irrational Animals column. You can follow her on Twitter here: @Martha_Gill.

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Lol enforcement: meet the man policing online joke theft

A story of revenge, retweets, and Kale Salad. 

A man walks into a bar and he tells a joke. The man next to him laughs – and then he tells the same joke. The man next to him, in turn, repeats the joke. That bar’s name is Twitter.

If you’ve been on the social network for more than five minutes, you’ll notice that joke theft is rampant on the site. Search, for example, for a popular tweet this week (“did everyone just forget about the part of 2016 when literal clowns would chase people with knives in public and nobody really did anything” – 153,000 retweets) and you’ll see it has been copied 53 times in the last three days.

One instance of plagiarism, however, is unlike the others. Its perpetrator is the meme account @dory and its quick Ctrl+C, Ctrl+V has over 3,500 retweets. This account frequently copies the viral posts of Twitter users and passes them off – word for word – as its own. Many similar accounts do the same, including @CWGirl and @FatJew, and many make money by promoting advertising messages to their large number of followers. Twitter joke theft, then, is profitable.

In 2015, Twitter promised to clamp down on the unchecked plagiarism on its site. “This Tweet from [user] has been withheld in response to a report from the copyright holder,” read a message meant to replace stolen jokes on the site. It’s likely a message you’ve never seen.

Dissatisfied with this solution, one man took it upon himself to fight the thieves. 

“I'm a like happy internet kind of guy,” says Samir Mezrahi, a 34-year-old from New York who runs the Twitter account @KaleSalad. For the last six months, Mezrahi has used the account to source and retweet the original writers of Twitter jokes. Starting with a few hundred followers at the end of December 2016, Mezrahi had jumped to 50,000 followers by January 2017. Over 82,000 people now follow his account.  

“I've always been a big fan of like viral tweets and great tweets,” explains Mezrahi, over the sound of his children watching cartoons in the background. “A lot of people were fed up with the meme accounts so it’s just like a good opportunity to reward creators and people.”

Samir Mezrahi, owner of @KaleSalad

I had expected Mezrahi to be a teen. In actual fact he is a father of three and an ex-Buzzfeed employee, who speaks in a calm monotone, yet is enthusiastic about sharing the best content on Twitter. Though at first sourcing original tweets for Kale Salad was hard work, people now approach Mezrahi for help.

“People still reach out to me looking for vindication and just that kind of, I don’t know, that kind of acknowledgement that they were the originals. Because all so often the meme accounts are much larger and their tweets do better than the stolen tweet.”

But just why does having a tweet stolen suck so much? In the grand scheme of things, does it matter? Did everyone just forget about the part of 2016 when literal clowns would chase people with knives in public and nobody really did anything?

Meryl O’Rourke is a comedian and writer who tweets at @MerylORourke, and now has a copyright symbol (©) after her Twitter name. In the past she has had her jokes stolen and reposted, unattributed, on Facebook and Twitter and hopes this symbol will go some way to protecting her work.

“It’s hard to explain how it felt... as a struggling writer you’re always waiting for anything that looks like recognition as it could lead to your break,” she explains. “When your work gains momentum you feel like your opportunity ran off without you.

“Twitter is a test of a writer’s skill. To spend time choosing exactly the right words to convey your meaning with no nuance or explanation, and ensure popularity and a chuckle, in the space of only 140 characters – that’s hard work.”

However, Mezrahi has found not everyone is bothered by their tweets being stolen. I found the same man I reached out to with a stolen tweet who said he didn’t want to speak to me because it felt too “first world problems” to complain. Writers like O’Rourke are naturally more annoyed than random teenagers, who Mezrahi says are normally actually pleased about the theft.

“If you go to [a teenager’s] timeline it’s always the same thing. They’re replying to all their friends saying like ‘I’m famous’, they’re retweeting the meme accounts saying like ‘I did it’… they don’t mind as much it seems. It’s kind of like a badge of honour to them.”

Sometimes, people even ask Kale Salad to unretweet their posts. College students with scholarships, in particular, might not actually want to go viral – or some viral tweets may accidentally include personal information. On the whole, however, people are grateful for his work.

Yet the Kale Salad account does have unintended consequences. Mezrahi has now been blocked by the major meme accounts that frequently steal jokes, meaning he had to create alternate accounts to view their content. But just because he can’t see them doesn’t mean they don’t see him – and he has noticed that these accounts now actually come to his profile to steal jokes he has retweeted, in a strange role-reversal.

“There are definitely times when they're picking up things that I just retweeted, like I know they're like looking at me too,” he says. “It feels like vindicated or validated that they come to me.”

Mezrahi now works in social media on a freelance basis, but would be open to making Kale Salad profitable. Earlier this year he set up an account on Patreon – a site that allows fans to pay their favourite creators. Some people didn’t approve of this, tweeting to say he is “just retweeting tweets”. So far, Mezrahi has three patrons who pay him $50 (£39) a month.

“I mean I spend a certain amount of time on this and I think it’s a pretty good service, so I've been thinking about monetisation and thought that might be a route,” he explains. He believes he is providing an important service by “amplifying” creators, and he didn’t want to make money in less transparent ways, such as by posting sponsored advertisements on his account. Yet although many online love Kale Salad, they don’t, as of yet, want to pay him.

“Twitter should buy my account because I’m doing a good thing that people like every day,” he muses.

Many might still be sceptical of the value of a joke vigilante. For those whose jokes aren’t their bread or butter, tweet theft may seem like a very minimal problem. And although it arguably is, it’s still incredibly annoying. Writing in Playboy, Rob Fee explains it best:

“How upsetting is it when you tell a joke quietly in a group of friends, then someone else says it louder and gets a huge laugh? Now imagine your friend following you every day listening for more jokes because people started throwing money at him every time he repeated what you said. Also, that friend quit his job because he made enough to live comfortably by telling your jokes louder than you can. Odds are, you’d quickly decide to find new friends.”

For now, then, Kale Salad will continue his work as the unpaid internet police. “As long as people like the service, I don’t mind doing it. If that's a year or two years or what we'll see how the account goes,” he says.

“Twitter is fun and I like the fun days on the internet and I like to help contribute to that.

“The internet is for fun and not all the sadness that’s often there.”

Amelia Tait is a technology and digital culture writer at the New Statesman.

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