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Medicine Science

How Did the 'Berlin Patient' Rid Himself of HIV? 107

Posted by Soulskill from the patent-pending dept.
sciencehabit writes: Researchers are closer to unraveling the mystery of how Timothy Ray Brown, the only human cured of HIV, defeated the virus, according to a new study. Although the work doesn't provide a definitive answer, it rules out one possible explanation. [R]esearchers point to three different factors that could independently or in combination have rid Brown’s body of HIV. The first is the process of conditioning, in which doctors destroyed Brown’s own immune system with chemotherapy and whole body irradiation to prepare him for his bone marrow transplant. His oncologist, Gero Hütter, who was then with the Free University of Berlin, also took an extra step that he thought might not only cure the leukemia but also help rid Brown’s body of HIV. He found a bone marrow donor who had a rare mutation in a gene that cripples a key receptor on white blood cells the virus uses to establish an infection. (For years, researchers referred to Brown as "the Berlin patient.") The third possibility is his new immune system attacked remnants of his old one that held HIV-infected cells, a process known as graft versus host disease.
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How Did the 'Berlin Patient' Rid Himself of HIV? More

How Did the 'Berlin Patient' Rid Himself of HIV?

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  • Host versus graft disease (Score:1)

    by Anonymous Coward

    Maybe the disease rejected him?

  • Missing in the Summary (Score:2, Interesting)

    by Anonymous Coward

    Although the work doesn't provide a definitive answer, it rules out one possible explanation

    ...that conditioning by itself likely cannot rid the body of the AIDS virus.

    • Re: (Score:1)

      by Anonymous Coward

      Although the work doesn't provide a definitive answer, it rules out one possible explanation

      ...that conditioning by itself likely cannot rid the body of the AIDS virus.

      No but a significant percentage of Europeans are resistant to HIV. Not sure what the news are here, Germans in general should have 25% chance of fighting off an HIV infection.

      • Re:Missing in the Summary (Score:5, Informative)

        by niado ( 1650369 ) on Friday September 26, 2014 @05:09PM (#48006155)

        Although the work doesn't provide a definitive answer, it rules out one possible explanation

        ...that conditioning by itself likely cannot rid the body of the AIDS virus.

        No but a significant percentage of Europeans are resistant to HIV. Not sure what the news are here, Germans in general should have 25% chance of fighting off an HIV infection.

        You're a bit confused. Some Europeans (between 4% and 16%) carry a mutatation [wikipedia.org] that reduces their likelihood of contracting specific HIV strains. The bone marrow donor mentioned in the summary had two copies of this mutated gene, which is a possible contributor to the "cure".

    • Re:Missing in the Summary (Score:5, Interesting)

      by ArmoredDragon ( 3450605 ) on Friday September 26, 2014 @12:58PM (#48004515)

      IMO he probably still has traces of the virus within his body somewhere, but in such small quantities that it's undetectable. Other viruses are known to do this, such as chickenpox, which can resurface later in the form of shingles if the immune system ever weakens. Except HIV feeds off of the immune system itself, so it's likely he'll never see symptoms of it again.

      However it would be unwise for him to do whatever he did to contract it in the first place as he could either spread his to somebody else or contract another variation of the disease that doesn't rely on the same receptor that he is now immune to (and yes, he does fit the "risk category" demographic if you haven't read his history.)

      • Little known fact: a person with HIV who has access to the right retroviral drugs and takes them on time is practically unable to transmit HIV during sex. There are now anecdotes about HIV positive men who have had sex without using a condom with hundreds of non-HIV positive men without a single instance of transmitting the virus.

        Of course, these people still transmit other STD:s.

        • Re: (Score:3, Insightful)

          by TangoMargarine ( 1617195 )

          Good for them, I guess? Still nothing I would ever want to validate experimentally...

        • Re:Missing in the Summary (Score:5, Insightful)

          by Anonymous Coward on Friday September 26, 2014 @01:25PM (#48004677)

          Call me old fashioned, but if you know you're HIV+, and have unprotected sex with hundreds of people ... you're an asshole.

          I find it hard to believe all of those people have had the benefit of informed consent.

          And, for what it's worth, yes, I do know people who are HIV+, and yes, they're gay men.

          Stuff like this is what people have been trying to combat.

          • Call me old fashioned, but if you know you're HIV+, and have unprotected sex with hundreds of people ... you're an asshole.

            I find it hard to believe all of those people have had the benefit of informed consent.

            And, for what it's worth, yes, I do know people who are HIV+, and yes, they're gay men.

            Stuff like this is what people have been trying to combat.

            Yeah, the reason why these anecdotes are believable is that they are based on criminal investigations and court proceedings. As you might guess, some of those hundreds of men were not too happy.

          • Re: (Score:1)

            by Anonymous Coward

            s /asshole/attempted murderer/

            FTFY.

          • i think you should be a 'felon' at that point.

          • Re:Missing in the Summary (Score:4, Funny)

            by mythosaz ( 572040 ) on Friday September 26, 2014 @03:03PM (#48005385)

            I assume everyone I sleep with has HIV.

            That's why I don't have to tell them about mine.

        • time is practically unable to transmit HIV during sex.

          No they are able to, just not likely. When it does happen, the results tend to be pretty bad as the virus that DOES spread tends to be resistant to multiple anti-HIV drugs, which means the recipient will be SOL when it comes to treatment and no amount of therapy will prevent the development of full blown aids.

        • What about the non-HIV positive women they had sex with?

          • What about the non-HIV positive women they had sex with?

            Penis in anus sex has a much higher risk of transmitting HIV compared to penis in vagina sex. We're talking something like a factor of ten difference.

            It has always been a little bit mysterious that HIV manages to spread epidemically among heterosexual people who don't use iv drugs in Africa. I don't know if this mystery has been resolved yet.

        • and takes them on time

          What's the rate on women forgetting to take The Pill and getting pregnant, anyway? Perhaps putting too fine a point on it, but I expect it's still a damn sight easier to get an abortion than to get un-HIV'd.

      • Re:Missing in the Summary (Score:4, Informative)

        by Gavrielkay ( 1819320 ) on Friday September 26, 2014 @01:56PM (#48004889)
        Actually, if what I remember is correct, people with that mutation mentioned are unable to get AIDS. Their T-cells lack the receptor that the virus attaches to. This was discovered a while back when certain people never got AIDS despite engaging in all the same risky behavior that caused people around them to get sick in droves. Apparently the mutation was enriched in Europeans because it also provided protection against the plague.

  • Simple. He's Immortal (Score:5, Funny)

    by Anonymous Coward on Friday September 26, 2014 @12:23PM (#48004201)

    He can't die, you fool, unless his head comes away from his neck.

    now that he's outed, expect a seven-foot lunatic with a sword to come after him.

  • Not a thorough analysis (Score:5, Funny)

    by pushing-robot ( 1037830 ) on Friday September 26, 2014 @12:23PM (#48004205)

    Does the subject possess any mysterious rings, amulets, or lamps?
    Does he make sacrifices to chthonic gods, and if so, which?
    Did he recently undertake a quest to bring together a collection of ancient magic gems?
    Is the hospital frequented by a wizard or a druid cult?

    I appreciate the work they did, but when they don't even consider the patient being swapped with his twin from an alternate dimension it's hard to call it rigorous.

  • His is the drill that will pierce the HIV-ens!

    • Re: (Score:1)

      by Anonymous Coward

      Take that, Viral!

  • graft versus host disease (Score:1)

    by Anonymous Coward
    Why does every slashdot article have to be about politicians...oh wait
  • there are only 2 things here:
    1. radiation treatment
    2. bone marrow from an x-man

    my money is on #2.

    • Re: (Score:2)

      by jd2112 ( 1535857 )

      there are only 2 things here: 1. radiation treatment 2. bone marrow from an x-man my money is on #2.

      Only problem is that the best match for super-healing happens to have an adamantium skeleton. Good luck getting bone marrow out of Wolverine!

  • Very interesting stuff. The far reaching implications of using this method to fight viral infections is fascinating.

  • Summary missing punchline (Score:5, Informative)

    by quantaman ( 517394 ) on Friday September 26, 2014 @01:04PM (#48004555)

    According to the summary

    Although the work doesn't provide a definitive answer, it rules out one possible explanation. [R]esearchers point to three different factors that could independently or in combination have rid Brown’s body of HIV.

    Unfortunately the summary forgets to mention the explanation that was ruled out or even clearly delineate the three different factors (though the latter was more the fault of the original article).

    From my reading of TFA:

    Explanation 1: Conditioning: The radiation that destroyed his immune system also killed off the HIV (because HIV lives in the cells of the immune system).

    Explanation 2: Shiny new immune system: The new bone marrow had a mutation that was immune to HIV and that cured him (maybe by detecting and killing HIV infected cells?).

    Explanation 3: Graft vs host: The new immune system killed off his old one, not just the HIV infected cells but all the old immune systems cells including those infected with HIV.

    So the researchers took chimps, extracted some stem cells (bone marrow?), infected them with SHIV (Simian HIV), destroyed their immune systems with radiation, then reinjected the uninfected stem cells.

    The SHIV quickly came back which rules out explanation 1.

    • Re: (Score:1)

      by Pro923 ( 1447307 )
      About explanation 2... I thought I remember reading sometime in the past that something like 10% of human beings are immune to HIV. Is that real - or not? If it's real, than that gives another boost to explanation 2...

      • Resistant would probably be a more accurate description than immune, with significant exposure even people with the mutation would still get infected eventually. Originally it was speculated that the mutation could have been selected for during the black death, but I believe that turned out to be largely bogus.

        • Re:Summary missing punchline (Score:4, Informative)

          by Gavrielkay ( 1819320 ) on Friday September 26, 2014 @02:07PM (#48004961)
          The black death appears to still be considered a possibility for how the mutation got enriched in the population. Another possibility is smallpox. And according to what I've read, it's more like 15% European heritage have one copy of the CCR5-delta 32 mutation which provides limited resistance and 1% got two copies and have strong resistance but not complete immunity since some forms of the virus use other attachment points.

          citation: http://www.nature.com/scitable... [nature.com]
      • The CD4 receptors on the surface of our T cells are used by HIV to gain entry into the cell. The concept is similar to a lock and key mechanism. A very small minority of people in the world (I thought it was less than 1% actually, not 10%), have a mutated CD4 receptor. So the key used by HIV to gain entry doesn't work, access to the cell's nucleus is blocked and replication of the virus does not occur.

    • Minor note: It's SIV, not SHIV. SHIV would stand for Simian Human Immunodeficiency Virus.

  • Looks like those curses from god just ain't what they used to be. :-)

  • Everyone can use some aids to help them with their daily lives.

  • Format the drive and reinstall all your software. Probably takes the same amount of time, too.

  • I know they are pronouncing him "cured".

    That's the funny thing about diseases like HIV.

    The simple fact is, it may STILL be in his system. Just, currently, in quantities far too low to be detected.

    But, give it a couple years. And out of his blood/bone marrow/organs, it'll come. And it'll multiply into life threatening numbers again.

    • Re: (Score:2)

      by sjames ( 1099 )

      It's already been a few years.

      • Re: (Score:2)

        by Chas ( 5144 )

        It's already been a few years.

        Yes. AND?

        Do people exposed to HIV immediately begin developing non-hodgkins lymphomas and a completely compromised immune system?

        No.

        Has this person POSSIBLY extended their life? Maybe.

        But going "It's been X years, he's clear!" with something like HIV is a dangerous precedent.

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