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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YouTube announces new measures against extremism – but where do they leave the far right?

Videos by alt-right commentators have arguably radicalised many online. Will Google's latest policies do anything to change this?

Within hours of the terrorist attack in Finsbury Park, Tommy Robinson was trending on Twitter. The former leader of the English Defence League accused the Finsbury Park mosque of “creating terrorists” in a series of tweets on his personal account.

More than 17,400 people have now tweeted about the 34-year-old, with many theorising he could have radicalised the attacker who allegedly shouted “I’m going to kill all Muslims” at the scene. At present, there is no evidence that the man arrested by police on suspicion of attempted murder is a fan of Robinson.

“People are saying I’m inciting hate,” said Robinson in a video uploaded to Twitter and YouTube after the attack. “I just tell the facts and the truth and I’m not going to apologise for that…

“If giving you quotes from the Quran that incite murder and war against us is inciting hate, I’m guilty. If telling you all the problematic problems that come from the teachings and scriptures of Islam, I’m guilty. But these are just facts.”

After describing the country as being at “war”, he goes on to say: “Please one person, just one, give me one example of me inciting hate.”

When we talk about radicalisation and terrorism, we are finally to understand that this extends beyond the work of Isis.

Just over a year ago, Labour MP Jo Cox was murdered by a white supremacist. This morning, Harry Potter author JK Rowling used Twitter to accuse columnist Katie Hopkins of contributing to radicalisation. The New Statesman’s own Media Mole notes how right-wing tabloids incite hate.

In particular, it is now evident how the far right radicalises online. In December 2016, a man fired three shots in a Washington DC pizza parlour that the alt-right (on 4Chan and YouTube) had accused of being at the centre of a paedophile ring.

The internet arguably allowed Anders Breivik, the Norwegian far right white supremacist who killed 77 people in 2011, to cultivate his extreme views. Alexandre Bissonnette, the white nationalist who murdered six men at a Québec City mosque in January, was described by many as an “internet troll”.

Earlier this year, a report by the Commons home affairs committee accused social media giants of not doing enough to tackle terrorism online. In response to this – and following a series of high-profile brands pulling their advertising from YouTube after it was featured on or by terrorism-related videos – Google, which owns the video-sharing site, has now announced four steps it is taking to fight online terror. But do these reflect the reality that there are many forms of extremism?

Google’s new guidelines speak of “terrorism” and “extremism” in broad terms. This means that videos glorifying or inciting terrorism will be treated the same whether they are from the far right, far left, or pro-Isis organisations.

Google’s four steps for tackling such videos include: using machine learning to identify videos glorifying violence, using a team of human flaggers to identify problematic videos, and using a "redirect method" to send potential Isis recruits towards anti-terror videos. Each of these steps is concerned with content that either breaks the law or violates YouTube’s policies.

The fourth step (or rather the third, as it is ordered in Google’s blogpost) is focused on non-illegal, non-policy violating content. For example, this could include videos that don’t directly incite terrorism, but arguably incite hate, such as those denying the Holocaust.

According to Kent Walker, Google’s general counsel, these could also be “videos that contain inflammatory religious or supremacist content”. Rather than being removed like the other offending videos, these will be hidden behind a warning, not have adverts on them (therefore preventing their creators from making money), and will not be eligible for comments. Essentially, as Walker writes, “that means these videos will have less engagement and be harder to find”.

It remains to be seen whether – or how – this will apply to the content of Tommy Robinson. YouTube’s steps will be taken on a video-by-video basis, meaning no far right commentator will be banned outright. Instead, YouTube simply won’t promote any offending videos, meaning they will not appear in their subscribers’ recommended feeds and will be difficult to find on the site.

In this way, Google has remained committed to free speech while doing more to tackle extremism on YouTube. Those like Robinson who claim to just “tell the facts” could arguably now be held to account for their actions. Many on the far right are careful to not explicitly advocate violence. Nevertheless, the loaded language used in their videos could arguably incite hate.

Paul Joseph Watson, a right-wing conspiracy theorist YouTuber with nearly one million subscribers, has never advocated terrorism, but has videos entitled “Islam is NOT a Religion of Peace” and “Chuck Johnson: Muslim Migrants Will Cause Collapse of Europe”.

In the past I have argued that allowing Google and YouTube to censor us in the name of “extremism” and “terrorism” is a troubling trend, but with these new promises, the company has walked the delicate line between the law and free speech. By allowing hateful, but not illegal, content to be hosted on its site and yet restricted from a wider audience, YouTube is taking a stand against extremists of all kinds.

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

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