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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Brain training: exposing the myth behind cognitive-enhancement games

A new study indicates that any benefits gained from brain games may be down to the placebo effect.

If you’ve ever searched for a quick-fix to mental lethargy, it’s likely that you’ve browsed through your smartphone app store to take a look at the latest offerings of brain-training games.

I certainly have. These games have been designed to sharpen people’s mental acuity, while offering “scientifically proven” means for improving IQs; through a variety of mini-games and careful documentation of improvements to intelligence parameters, people would wield the tools needed to craft the desired, smarter minds that the apps promise.

And the market for them has showed no sign of slowing down. In the space of a few years, the demand for the apps has made the industry a billion-dollar one, with growth expected to continue. A couple of the most popular apps have included Lumosity, a web-based program boasting more than 50m users seeking to “improve memory, attention, flexibility, speed of processing and problem solving”, and mobile-based Peak, whose similar goals and striking visuals entice potential users.

Though the apps have had huge amounts of success, there is a new body of research emerging to suggest that the successes may not be as a result of the games themselves, but because of the placebo effect.

The placebo effect is a phenomenon in which a dummy treatment or process can cause significant changes in a person – simply because that person believes the placebo (posing as a real treatment) will help them. With medication, it can be the mere presentation of a sugar pill disguised as a medicine which can cause a patient to get better. And in the case of apps and games, it seems that anything which promises users cognitive benefit, is more likely to do so.

In a study entitled “Placebo effects in cognitive training” published on Monday in the journal Proceedings of the National Academy of Sciences, researchers found that participants who engaged in brain-training games for a single, one hour session showed improvements in IQ by up to ten points, but only if they believed the games would benefit them.

The group of cognitive scientists from George Mason University, Virginia, set up the experiment in a particular way to determine whether or not the placebo effect was involved.

50 participants were recruited, after two different posters asking people to sign up to a study were plastered around campus: one labelled “brain training & cognitive enhancement” and the other “email today & participate in a study”. The rewards for the former promised boosts in intelligence, while rewards for the latter granted study credits. Unknown to participants, however, was that both tests were the same, meaning any resulting changes to IQ were as a result of what participants were telling themselves about the tests.

The tests centred around the engagement of working memory and other factors to impact fluid intelligence – a type of intelligence which revolves around the application of logic and reason, independent of acquired knowledge. Those who chose to sign up to the “brain training & cognitive enhancement” study, aka the placebo study, were the ones to show remarkable gains in IQ after completing a post-brain games IQ test; gains of five to ten IQ points being made. Those who signed up for the control showed no signs of improvement.

Speaking to the Huffington Post, researcher and co-author of the study Cyrus Foroughi said: “Placebos are very pervasive and they have to be controlled for in a tremendous number of fields. This field is no different. So we put together the study to actually test whether expectation for a positive effect can lead to a positive outcome.”

Within the scientific community, frustration had already mounted as a result of the falsely promoted uses of brain games, particularly as tools to reverse age-related, cognitive-faltering illnesses such as Alzheimer’s disease. Overstated claims through advertising were enough to encourage scientists to sign an open letter in 2014, condemning the inaccurately purported benefits of brain training games. Earlier this year, Lumosity was fined $2m by the Federal Trade Commission for deceiving consumers with “unfounded claims”.

The recent findings strengthen this position, as the effects of cognitive training games seem less to do with the content of the games themselves, and more to do with what users tell themselves will happen after a session of, brain-training puzzle bonanzas. That’s not to say the games themselves don’t offer some benefit – it’s just that further clarification is needed to understand what they exactly contribute to, with the placebo effect factored in.

While scientists expand on their research to pinpoint the real effects of brain games, it seems for now that the best options to keep our brains active are the ones we are most familiar with: learn a language, do some exercise, or maybe just read a book.