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Medicine United Kingdom

A Third Person May Have Been Cured of HIV (newscientist.com) 47

An anonymous reader quotes a report from New Scientist: Following news of a man in the UK who has been free of HIV since his cancer treatment, a similar case has been reported by researchers who treated a patient in Germany. Together, they add to evidence that it may be possible to cure HIV. The virus infects cells of the immune system, which are made in the bone marrow. A man known as the "Berlin patient" was the first person to become HIV-free after cancer treatment, back in 2007. To treat his leukemia -- a cancer of the immune system -- he was given a treatment that involved killing nearly all his immune cells with radiotherapy or drugs, and then replacing them with cells from a donor. This donor was naturally resistant to HIV, thanks to a rare but natural mutation in a gene called CCR5.

A possible third case was then announced today, at the Conference on Retroviruses and Opportunistic Infections in Seattle. Biopsies from the gut and lymph nodes of this "Dusseldorf patient" show no infectious HIV after three months off antiviral drugs -- only old fragments of viral genes that wouldn't be able to multiply, says Annemarie Wensing of University Medical Center Utrecht in the Netherlands, who worked on this case. This is just like the Berlin and London patients, she says. Researchers are tracking the few other people who have HIV and have then had a bone marrow transplant from someone with the CCR5 mutation in a collaboration called IciStem. As well as the three reported so far, there are two others who haven't yet stopped taking antiviral medications, says Javier Martinez-Picado of the IrsiCaixa AIDS Research Institute in Barcelona.

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A Third Person May Have Been Cured of HIV

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    • Recently the second patient was cured [slashdot.org].

      Hopefully there will be more and more as time goes by- but this doesn't seem to be a technique that can be done en masse yet.

      • Yes, but it occurs to me that if sexual revolutionaries want to continue their lifestyle of ignoring sexually transmitted diseases, the least they could do is a kickstarter for a specialized hospital that finds cures like this one.

      • by brcmrgn ( 824236 ) on Thursday March 07, 2019 @11:31AM (#58231208)
        I had a bone marrow transplant in 2000 for Leukemia. My donor had no allergies and a different blood type and now, so do I. The no allergies was a nice benefit, but I wouldn't recommend a bone marrow transplant unless there is no alternative. At the time, one-year survival odds were about 60%. The process has improved, but there are still lots of ways to not survive a BMT. I was off work for 6 months and it wasn't until 2 years after the transplant that I could work 40 hours every week. It took 4 years for me to wean off of steroids. I am still living with side effects of the chemo and radiation user to kill my bone marrow -- Cataracts and type-2 diabetes are common side effects.
    • obligatory xkcd quote.
  • Is the killing of the current immune system necessary for bone marrow transplantations to work? Or for HIV to be cured?

    Either way, how dangerous and intrusive is the process and what does it cost?

    In effect, is this or is this not a method that is viable to eradicate the virus in this species? It sounds too complicated a procedure for that.

    • by guruevi ( 827432 ) on Thursday March 07, 2019 @09:33AM (#58230580)

      For most organ transplants you need to kill or suppress the immune response. This is a very dangerous procedure, HIV suppressants exist and are arguably safer. This also includes a surgery for the marrow transplant, risks exist for both the donor and receiver.

      It's pretty costly and won't become the mainstream for curing HIV since you need a very specific set of donors and the pool of sick people is simply too large. These are happy accidents that come with curing something else (eg cancer) and give researchers a pathway to look down at but not a fix that will be on the market tomorrow.

      • by Kokuyo ( 549451 )

        Thank you, that was the impression I had as well.

        • The Delta32 mutation of the CCR5 gene [sciencedaily.com] causes resistance to HIV and other plagues such as the Black Death. [nowiknow.com] It occurs naturally in some people as a result of selection pressure of the plagues. Even though the methods used here to cure HIV are rather costly and dangerous and won't become mainstream, what it shows is that the Delta32 mutation of CCR5 gene not only provides resistance to HIV by turning of a receptor that the virus needs to attach to the cell in order to infect the host but also cures it outrig
      • The current method is much, much more dangerous than tri therapy no question about it. Last time I checked someone with HIV had the life expectancy of someone with diabetes so youâ(TM)ll get to grow old etc. Current treatment is so good thst often your levels are so low in your blood that its not clear if youâ(TM)re still contagious.
  • The "cure" involves full-body irradiation to destroy the immune system, and then a bone-marrow transplant from someone that's HIV resistant. In general, these cures have been a side-effect of someone battling pretty serious cancer.

    • by Nidi62 ( 1525137 )

      The "cure" involves full-body irradiation to destroy the immune system, and then a bone-marrow transplant from someone that's HIV resistant. In general, these cures have been a side-effect of someone battling pretty serious cancer.

      If it turns out there is pretty good evidence that this treatment works, it may lead to funding for research into less invasive but equally effective treatments.

      • It works because the new cells don't have the receptor the virus uses... it is like if you had nose cancer, and we grafted a new nose on that lacked nostrils. Now you can't get the common cold! But it doesn't map to widespread treatment because you don't want to graft new noses onto everyone. You can't nuke that receptor in other people otherwise, because they'll constantly grow new immune cells from their marrow that have them. And without looking it up, there's whatever this receptor normally does tha
  • by fadethepolice ( 689344 ) on Thursday March 07, 2019 @09:43AM (#58230626) Journal
    So, can we just remove some bone marrow stem cells from someone, snip in the CCR5 Gene and, put the stem cells back in to cure HIV? This is very interesting as it is a medical procedure that would not need FDA Approval, and would have a huge impact on the bottom line of many drug companies. I'm getting some popcorn. to see hwo this plays out.
    • Re:CRISPR (Score:4, Informative)

      by Gilgaron ( 575091 ) on Thursday March 07, 2019 @09:59AM (#58230684)
      Well you also need to kill off all of their original marrow. And, while I looked it up briefly and its role isn't fully understood, it is likely that those with the novel CCR5 gene are more susceptible to flavivirus infection while being resistant to HIV and pox viruses. The immune system isn't really set up to allow quick firmware updates.
    • In principle yes, in practice naive use of CRISPR to do gene editing on an adult organism results in cancers sprouting up like weeds all over the place. CRISPR is better than previous methods, but it's still not perfect. You can gene edit a designer baby that is immune to HIV. But to take an adult patient and 'fix' his genes... not so much. Not yet anyway
  • it currently more like âzPerson receiving leg transplant after stepping on landmine was cured of athletes foot !!!âoe

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