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Medicine Science

Two More HIV Patients Now Virus-Free Thanks To Bone Marrow Transplant 159

Posted by Soulskill
from the cures-that-aren't-easy dept.
Diggester tips this quote from NBC News: "Two men unlucky enough to get both HIV and cancer have been seemingly cleared of the virus, raising hope that science may yet find a way to cure the infection that causes AIDS, 30 years into the epidemic. The researchers are cautious in declaring the two men cured, but more than two years after receiving bone marrow transplants, HIV can't be detected anywhere in their bodies. These two new cases are reminiscent of the so-called 'Berlin patient,' the only person known to have been cured of infection from the human immunodeficiency virus."
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Two More HIV Patients Now Virus-Free Thanks To Bone Marrow Transplant

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  • by Tr3vin (1220548) on Friday July 27, 2012 @03:47PM (#40795025)
    In other news, a representative from Chick-Fil-A has stated that the company does not support bone marrow transplants.
  • by Anonymous Coward

    I do you a big favor, and later you do me some favors, deal?

  • Immunosupressants? (Score:5, Insightful)

    by Anonymous Coward on Friday July 27, 2012 @03:53PM (#40795115)

    Don't they have to take stuff to immunosuppress for the rest of their life with the bone marrow transplant? Trade one immunodeficiency for another?

    • by slazzy (864185) on Friday July 27, 2012 @03:57PM (#40795149) Homepage
      Yes, you do have to take immunosuppressant drugs for bone marrow transplant will reject it. Probably also steroids such as Prednisone as well.
      • by MozeeToby (1163751) on Friday July 27, 2012 @04:25PM (#40795493)

        That all depends on a host of factors. If the transplant came from a brother or sister (or from yourself, which is becoming more and more common these days) the rate of rejection is very low (still not 0, but close to it). If it's coming from a stranger rejection is more likely, though that again depends on how good the match is and how the new immune system reacts. There are even cases where doctors will chose a 'less good' match for patients with persistent cancer because it increases the chances of the new immune helping to finish off the cancer. At least, that's what they told me when I was in to donate.

        Incidentally, it's not the host's body that rejects the bone marrow, it's generally the other way around. The new bone marrow rejects the host, called graft vs host disease.

        • by Anonymous Coward

          It's been a few years since I followed up on BMTs, but even with Brother and Sisters, the rate of rejection is higher than you claim. In 2005, the mortality rate at 5 years was (iirc) around 50%.

          The sad fact is BMT are basically an attempt to jump start the immune system. First they destroy it, then they plant the new stuff, and finally, they hope it catches.

          Yes, you can die from a BMT. (Or you can suffer grade 4 Mucositis which is also fun).

          You can die from a (very) simple infection when the bone marrow

          • by Tesen (858022)

            2 years for my mother, the anti-rejection drugs, the previous cancer treatments and the act of nuking her immune system for the BMT just weakened her way to much. She ended up in rejection and then died of Pneumonia because even the industrial strength antibiotics they gave her could not help.

        • by slew (2918)

          That all depends on a host of factors. If the transplant came from a brother or sister (or from yourself, which is becoming more and more common these days) the rate of rejection is very low (still not 0, but close to it). If it's coming from a stranger rejection is more likely, though that again depends on how good the match is and how the new immune system reacts. There are even cases where doctors will chose a 'less good' match for patients with persistent cancer because it increases the chances of the new immune helping to finish off the cancer. At least, that's what they told me when I was in to donate.

          Incidentally, it's not the host's body that rejects the bone marrow, it's generally the other way around. The new bone marrow rejects the host, called graft vs host disease.

          I don't know about this case, but in standard BMT, a full histocompatible match with siblings isn't that likely (of course this doesn't fully correlate to the rate of rejection).

          AFAIK, Since one set of HLA (human leukocyte antigen) genes comes from your mother and one set comes from your father, there is roughly only a 1 in 4 chance that your brother or sister inherited the same two sets of HLA genes that you have.

          Of course you can attempt to use a partial match (there are 4 genes per set so the odds aren't

    • by brainzach (2032950) on Friday July 27, 2012 @04:06PM (#40795279)

      You only have to take immunosuppressants for a year or two with a bone marrow transplant. The bone marrow will learn to recognize your body after a while.

      The real danger is there is about 15 to 50% dying from the treatment itself. It is probably better to use current HIV treatments and only use the bone marrow transplant as a last resort, similar to what they do for cancer.

      • by MozeeToby (1163751) on Friday July 27, 2012 @04:30PM (#40795527)

        I was told the death rate is ~10% from the radiation to kill the patient's current bone marrow, ~5% due to graft vs host disease, and the rest of the fatality rate is due to the cancer not really being gone when they do the transplant. So the actual fatality rates would be much closer to the 15%, less still if you are doing it to otherwise healthy patients, and if you have a perfect match (from a sibling generally) the graft vs host disease rate will go to near zero. I bet you could push it down to 5%, still probably not worth it for most people... but I could imagine women who want to have kids taking the risk for one thing (though a bone marrow transplant might make getting pregnant risky in and of itself, just using it as an example).

        • The mortality rates have a lot to do with the health of the patient and how well of a match they can get. Things get tricky because having graft vs hosts disease helps cure the cancer part because it will attack cancer cells before the rest of the body.

          The challenge is finding someone who is an exact match and have the genetics that is resistant to HIV. It might work for those lucky few, but people already have challenges finding a match without the HIV criteria.

          • by alantus (882150)

            The challenge is finding someone who is an exact match and have the genetics that is resistant to HIV. It might work for those lucky few, but people already have challenges finding a match without the HIV criteria.

            FTFA: "The findings may not apply to all patients. Both men were a little unusual in that they had a genetic mutation that can make immune cells resistant to infection by HIV. Their new immune cells, however, which came from the donors, are fully susceptible to the virus."

      • by EvanED (569694)

        [This is a little bit in reply to your child post as well that lists additional statistics]

        The real danger is there is about 15 to 50% dying from the treatment itself.

        Jesus, I didn't realize that the transplant was so risky. I'd have guessed that the "didn't really get the cancer" part would get a lot of people, but the other problems I'd have not expected. Even MozeeToby's idealistic 5% is surprisingly high to me.

        It's sometimes depressing how little we know about how the body works and how little we can do

        • Yeah, I was surprised when I heard it to but the more you think about it the more it makes sense. A person's bone marrow is firmly rooted inside their bones, pretty much the only way to kill it without killing the person immediately, is to attack it with something that kills fast dividing cells preferentially. That can be done with extremely high doses of some chemotherapy drugs (read as 'poison') or, more commonly, through radiation. It's a very, very thin line between killing someone's bone marrow and

      • You only have to take immunosuppressants for a year or two with a bone marrow transplant. The bone marrow will learn to recognize your body after a while.

        I am going to be having a bone marrow transplant to fix my cancer in the not terribly distant future, and my doctor has told me that *ideally* I will have to take strong immunosuppressants for a year or two, plus steroids for basically the rest of my life.

        However, there is a non-zero chance that I will be taking some fairly strong immunosuppressants for t

      • by ceoyoyo (59147)

        The study I'm currently working on is running about a 2-5% mortality rate from the immunoablation and transplant. It is an autologous transplant though, so there's no risk of rejection.

        Still, bone marrow is hard to come by, it is more dangerous if you're using a donor, and HIV infections can be very well controlled.

  • Well, yes and no. (Score:4, Informative)

    by Frosty Piss (770223) * on Friday July 27, 2012 @03:53PM (#40795119)

    There is not test or proof that they are 100% virus free. The test can only show that there is a high STATISTICAL probability that they MIGHT be virus free.

    • Re:Well, yes and no. (Score:4, Informative)

      by Antipater (2053064) on Friday July 27, 2012 @03:57PM (#40795153)
      That is currently true. However, an up-and-coming competitor for the AIDS-cure crown is a therapy that flushes latent HIV out of dormancy, to be monitored or killed. So it soon might be possible.
    • by 140Mandak262Jamuna (970587) on Friday July 27, 2012 @03:59PM (#40795177) Journal

      There is not test or proof that they are 100% virus free. The test can only show that there is a high STATISTICAL probability that they MIGHT be virus free.

      It reminds of the story about three professors walking down a country lane in Scotland. They see a black cow. The astrophysicist immediately declares, "All the cows in Scotland are black!". The professor of statistics interjects, "You are generalizing too much. All you can say is, the statistical probability of finding a black cow in Scotland is above zero. That is all."

      The professor of mathematics looks at them and says, "That is also a generalization, my friend. All we can say now is, this side of that cow is black".

    • by sjames (1099)

      That is true of any test though. No test is 100% accurate and no test if performed correctly 100% of the time.

    • Every test is like that, not medical test (or otherwise) can tell you more then a statistical chance one way or the other.
      But if you take the test multiple times you get a guarantee, for all intents and purposes.

    • by Pulzar (81031)

      high STATISTICAL probability that they MIGHT be

      Errr.. what, now? "Might be" is already an indication of probability, although a very vague one. It doesn't make sense to say that something has a "90% of maybe" chance of being right.

      In other words, what you wanted to say is that the test can show that there is a high probability of being virus free, but it can't prove it.

    • by Vellmont (569020)

      But that's true of anyone. You or me included.

      You're really just splitting hairs at this point. If you don't have any symptoms, and can't pass on the virus, and aren't receiving active treatment for the disease (virus cocktail)... in what sense could you be said to have HIV?

  • by rmdingler (1955220) on Friday July 27, 2012 @04:00PM (#40795193)
    Just how prevalent is this genetic mutation? IANAD, but assuming there must also be a very close match as with other transplants, will this help a few or many?
    • by realityimpaired (1668397) on Friday July 27, 2012 @04:13PM (#40795363)

      About 1% in northern Europeans, and it's not known to occur in other racial groups... they happened to be doing a story on the Berlin patient on CBC a few days ago, and I was listening to it.

      http://www.cbc.ca/player/News/ID/2260029968/ [www.cbc.ca]

      And as you point out, whether a person is a good match for a bone marrow transplant is a big question... it's significantly harder to find a match for a bone marrow transplant. The video goes into detail on it.

    • I read that the donors for these two men do not have the gene that gives resistance; that their possible cure is a result of them staying on their anti-retroviral meds throughout the transplant process, so that the virus never got the chance to establish itself in the new immune system. Actually quite a bit more interesting than the Berlin patient given how hard it is to find a matching bone marrow donor, let alone one that also has the HIV resistance gene. Actually, this is a big boost for just how effec

  • Ah, yes. (Score:5, Funny)

    by tgd (2822) on Friday July 27, 2012 @04:09PM (#40795325)

    Just goes to show, when you have a virus you can't get rid of, reboot and re-install.

  • The first humans cured of the HIV virus, and they get the reward of taking immunosuppressive medications, possibly for the rest of their life. This is the medical equivalent of napalming the village in order to save it...

    • by reub2000 (705806)

      Sounds more like starting smaller fires in order to control a much larger fire.

    • by Vellmont (569020)

      These people had leukemia. The bone marrow transplant was to cure the leukemia. Getting bone marrow that's immune to HIV was just a bonus.

    • by DM9290 (797337)

      The first humans cured of the HIV virus, and they get the reward of taking immunosuppressive medications, possibly for the rest of their life. This is the medical equivalent of napalming the village in order to save it...

      it worked in Vietnam!

  • Didn't they already do this with Magic Johnson for exactly $200,000??
  • Become a donor (Score:5, Informative)

    by QuantumRiff (120817) on Friday July 27, 2012 @05:17PM (#40796077)

    Lots of people don't realize anyone can be a bone marrow donor.. Be the Match [bethematch.org] runs a large registry. I clicked a few buttons on the website, and 2 weeks later, had a cheekswab in the mail. Probably simpler than registering to be a donor on my Drivers License, because I didn't have to wait at the DMV :)

    This is somewhat off-topic, since it doesn't have to do with the treatment, or treatment for aids, but Bone Marrow transplants are needed for lots of cancers too.

    • Lots of people don't realize anyone can be a bone marrow donor..

      Apparently not me (They don't allow gay people to donate - even if I am HIV-)

      • I really don't get why there's such a pouty attitude from gay Americans about this. Guess what, you're in a high-risk, high-rate group with about 21% infectiona and half don't even KNOW they're infected. The healthcare community isn't afraid of passing The Gay through blood transfusions. I'm African American, if I were gay the infection rate for my demo would be around 40%!

    • by Jeng (926980)

      Thank you for posting that, I had no idea it was that easy to become a blood marrow donor.

    • Not quite anyone. You cannot be a bone marrow donor or even a blood donor in some countries, like New Zealand, if you lived in the UK during the outbreak of BSE/CJD.
      • Many countries also won't take blood if you have lived in (or been in relationship with someone from) Sub-Saharan Africa

    • Are you quite sure it's anyone, aside of course for precluded groups. I thought that the original Berlin Patient got a transplant from someone who seemed to have a kind of genetic immunity to HIV?

  • What kind of bone marrow they are looking at, does this mean I kind sell my bone marrow to the highest bidder? Or does it need a specific kind of bone marrow or patient?
  • These two new cases are reminiscent of the so-called 'Berlin patient,' the only person known to have been cured of infection from the human immunodeficiency virus.

    There is some evidence to suggest [npr.org] "Berlin Patient" Timothy Ray Brown may not actually be cured of HIV. They just don't know for sure.

  • Obviously this is far from a mass cure. Even if it is develops into a technique that can be widely applied, for low cost - there will be plenty who can't afford it (because pharmaceutical companies, when it comes down to it, care about shareholders not sick people) and there will be plenty who don't know they are infected, and continue to infect others. If any treatment requires your 'good' cells to overwhelm the cells with HIV DNA in them, its going to take a long time. This is not a shot-in-the-arm treatm

  • Of which we've been fed hundreds of similar stories about HIV/AIDS over the decades.



    1> You'll forget all about it in a day or so... 2> It won't change anything about the current theory on HIV/AIDS... 3> You'll come away from this feeling like everything's going to be OK, while still believing everything about HIV/AIDS you've been told by "the authorities", who constantly lie about HIV/AIDS stats, your risk of infection with "HIV", and your chances of developing "AIDS"...

    Back in the early 90

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