Patient 'cured' of HIV after bone marrow transplant

[damyanti]

An Aids patient appears to have been cured of the disease after receiving a bone marrow transplant, his doctors said yesterday.

The 42-year-old, who had been infected for more than a decade, is showing no signs of the virus 20 months after the treatment.

The man, a Berlin-based American also suffering from leukaemia, was primarily given the bone marrow transplant to treat his blood cancer.

But his leukaemia specialist Dr Gero Huetter recalled that one in 1,000 Westerners carry a genetic mutation that seems to make them resistant to HIV infection.

So he set out to find someone carrying the gene among donors that matched the patient’s marrow type. Out of a pool of 80, the 61st person tested carried the proper mutation and the bone marrow was transplanted.

Berlin’s Charite hospital say tests on his bone marrow, blood and organs are clean.

‘We waited every day for a bad reading,’ Dr Huetter said. ‘It has not come.’

Experts say the procedure, which required the patient to come off his Aids drugs, is too costly and dangerous to employ as a first-line cure.

But it should inspire a greater interest in gene therapy to fight the disease that has infected 33million people worldwide.

However, London professor of epidemiology David Roth, said: ‘That’s a long way down the line because there may be other negative things that go with the mutation that we don’t know about.’

And Dr Huetter warned it is not certain his patient is cured, because the virus is wily and there could always be a resurgence.’

[mkemse]

INtresting, my only concenr is this is just 1 person world wide, i would like to see them test others over a perid of time and see what happes, but to base that story on just 1 persaon world wide, i have a ahrd time believing it, but i realy appriciate you posting it,
My disbelief has nothing to you with you at all you only post what you see and read
But I am sure tons more tests and chartingon more then 1 oerson has to be done to give a story like that any credability at all

[Ragoczy]

This is an interesting and promising development, I'll be curious to see how things to proceed.

Regardless of the efficacy of transplants for HIV, bone marrow transplants are an important treatment and not enough people are registered as donors. It costs you nothing to get on the bone marrow registry and there's no obligation even if you're a match for someone -- but if you are, the procedure might have a little discomfort, but saves a life. It's a fair trade.

[denuseri]

Cool beans , I am happy to hear this news, this disease has hung over my generation and many others for too long, it is nice to know that mabey somewhere out there on the horizion hope still exists.

Thanks for this informative post damyanti

[lucy]

Umm, to be honest, i think HIV-infections shouldn't be too much of a problem in most of the western civilizations. There's protection (for those careful enough to use it), there's treatment (for those who messed up when the should have protected themselves). So i don't really understand the fuss that's being made about HIV and aids.

Unlike with many or most other diseases most people who are infected with HIV could have avoided exactly that.

[fetishdj]

Not all of them. Its not quite as clear cut and simple as 'having unprotected sex or sharing drug needles gives you AIDs', for all that the publicity about it seems to suggest. And drug treatments as they stand are no 'cure', they merely delay the inevitable.

There are many HIV postive patients out there who were born with the virus due to their mother being infected. There are many more who were infected because they happened to have a blood transfusion from blood that was not screened or blood products (like factor 8 for Haemophilliacs) derived from donors who were HIV positive and did not know it at the time. Some sources of transfused blood in America were notorious for not properly screening blood and, at the same time, taking it from those who were willing to give blood in exchange for money - often drug addicts or the homeless. Add to the fact that, for many years, we either did not know HIV existed and/or denied its existence and so did not screen for it anyway - even in blood transfucion centres that did do proper screening. Not sure what the situation for blood donation in America is like now but I do hope it is better than the horror stories we were told while at university.

So there are many who were infected who could not have known they were exposed or even had a choice in the matter.

HIV is one of the most insidious viruses known (though the flu may beat it by being more successful in an evolutionary manner). The 'trick' of disabling the immune system means it can reproduce without hinderance and there is nothing the human body can do about it - you can't have a vaccine, you can't build an immunity because you have no immune system. I beleive the drug treatments work partially by bolstering the immune system - increasing white cell counts.

There was a report of a cohort of Thai prostitutes who had apparently developed an immunity and were therefore being extensively studied to see how they had done it. I wonder if this is a follow up to this (been a while since I looked at the literature).

HIV is also a very friable virus. It cannot live outside the body for very long (hence you cannot catch it from toilet seats...). The real worry would be if it adapted to do this and became airborne rather than transmitted via blood to blood contact.

One success is not worldwide success, it is true... but this is a trial treatment and they usually happen this slowly - one at a time. The problem here seems to be finding a donor who is both cross matched for bone marrow and has the mutation.

[lucy]

Not all of them. Its not quite as clear cut and simple as 'having unprotected sex or sharing drug needles gives you AIDs', for all that the publicity about it seems to suggest. And drug treatments as they stand are no 'cure', they merely delay the inevitable.

You're of course completely right when you say that what i said doesn't hold true for all. But for the vast majority it does. I cannot help but wonder that so many people who could and should know better still manage to get the virus.
For example, barebacking has become very common again in the Swiss gay community. Women travel to Jamaica or Kenia for sex, and they're foolish enough to do it unprotected, a guy has been convicted yesterday here because he beat hookers up when they didn't want to have unprotected sex.
So, what i see is a lot of stupidity and irresponsible behaviour.
For all the others who did nothing wrong, i'm truly very sorry.

And unlike a lot of people, especially among teenagers, i'm fully aware that it's a treatment, not a cure. And not an easy treatment either.

[Dr_BuzzCzar]

I've, unfortunately, been doing a fair amount of research on BMT procedures and reading on clinical trials pretty much everywhere for my wife who suffers from one of the forms of leukemia. I realize that the results of this procedure citied above is anecdotal but when you're staring the alternative in the face and that alternative is death, those anecdotes can be pretty impressive. I can't speak for all transplants but for leukemic bone marrow transplants the fatality rate is between 20%-30% depending on several factors so that is a serious consideration and tends to make BMT a very late treatment option. There's another whole story on when or if the BMT should be done due to "clean" remissions, drug resistances, patient's age and health, etc

As I understand it the principles determined from Dr Huetter's work may eventually apply the blocking methodology of the genetic resistance to other treatments because matching marrow and the genetic mutation for AIDS patients is pretty near zero.

There are 1.3 million Americans on the marrow donor list, why not add yours? You could save a life.

[damyanti]

There are 1.3 million Americans on the marrow donor list, why not add yours? You could save a life.

U.S. has the population of 300 million, but only 1.3 million are registered as the bone marrow donors?

[Ragoczy]

U.S. has the population of 300 million, but only 1.3 million are registered as the bone marrow donors?

That sounds about right, though I don't know the exact number for the US. There are only about 11 million donors registered world-wide.

The sad thing is that "registering" costs nothing and consists of nothing more than a blood sample. If called on to donate, it's most likely going to be nothing more than the equivalent of an extended blood donation -- but even if marrow is needed it's a simple outpatient procedure.

Marrow donation is all a numbers game right now. The more people in the registry, the more likely it is there'll be a match, but with so few people registered it's a virtual certainty that people are dieing because others spend a day of their time on a donation.

It's a very worthwhile thing to do -- imagine being able to go into a clinic for a day and then spend the rest of your life thinking: "I saved someone's life."

http://www.marrow.org/HELP/Join_the_Donor_Registry/Myths_%26_Facts_about_Marrow_Don/index.html

[lucy]

Thanks for the link, Ragoczy. Now that i know such a list exists i think i'll get on that list too.