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Medicine Science

Oldest Patient Yet Cure of HIV After Stem Cell Transplant 49

An anonymous reader quotes a report from Reuters: The oldest patient yet has been cured of HIV after receiving a stem cell transplant for leukaemia, researchers reported on Wednesday. While the transplant was planned to treat the now-66-year-old's leukaemia, the doctors also sought a donor who was naturally resistant to the virus that causes AIDS, a mechanism that first worked to cure the "Berlin patient," Timothy Ray Brown, in 2007.

The latest patient, the fourth to be cured in this way, is known as the "City of Hope" patient after the U.S. facility in Duarte, California, where he was treated, because he does not want to be identified. As well as being the oldest, the patient has also had HIV the longest, having been diagnosed in 1988 with what he described as a "death sentence" that killed many of his friends. He has been on antiretroviral therapy (ART) to control his condition for more than 30 years. [...] Scientists think the process works because the donor individual's stem cells have a specific, rare genetic mutation which means they lack the receptors used by HIV to infect cells.
"Scientists think the process works because the donor individual's stem cells have a specific, rare genetic mutation which means they lack the receptors used by HIV to infect cells," adds Reuters.

"After the transplant three and a half years ago, which followed chemotherapy, the City of Hope patient stopped taking ART in March 2021. He has now been in remission from both HIV and leukaemia for more than a year, the team said."

Researchers in Spain also presented a case of a 59-year-old woman who is considered to be in a state of viral remission. "She has now maintained a fully suppressed viral load for over 15 years," reports NBC News. "Unlike the handful of people either cured or possibly cured by stem cell transplants, however, she still harbors virus that is capable of producing viable new copies of itself. Her body has actually controlled the virus more efficiently with the passing years, according to Dr. Juan Ambrosioni, an HIV physician in the Barcelona clinic."
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Oldest Patient Yet Cure of HIV After Stem Cell Transplant

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  • by sg_oneill ( 159032 ) on Wednesday July 27, 2022 @11:59PM (#62740214)

    So this is really fascinating, in that what was possibly a one or two off fluke seems to be something thats kinda repeatable now, which means we have a mechanism AND we seem to have narrowed it down to specific genetics and cellular mechanisms.

    The question is, can we create a CRISPR type thing to get into the body and start modding existing bone marrow cells to convert them to the HIV resistant variety.

    • Re: (Score:3, Informative)

      by backslashdot ( 95548 )

      Yes. Here are two references out of dozens: https://www.cell.com/molecular... [cell.com]
      https://www.sciencedirect.com/... [sciencedirect.com]

      The problem is that the FDA won't allow CRISPR on a "healthy" person, even if he has HIV because the retrovirals work really well as long as you keep taking them. And by work really well I mean they are a nice revenue stream for the Pharma bros. A Chinese doctor being thrown in jail thanks to an international hissy fit for doing CRISPR didn't help.

      • The Chinese doc tried to use CRISPR on someone HIV-negative, in an attempt to make them immune. It wasn't an attempt at an HIV cure.

      • by ArmoredDragon ( 3450605 ) on Thursday July 28, 2022 @01:24AM (#62740338)

        No, the FDA is just ass slow. I've been needing treatment for years now for keratoconus. FDA only approved corneal crosslinking in 2016 even though it has been a thing for 20 years. Pharma could not have had anything to do with that because the only treatment prior to crosslinking was just to wait until you go totally blind and then you get a cornea transplant. Insurance companies wouldn't have had anything to do with it because corneal crosslinking is a hell of a lot cheaper and provides for a much better outcome than a cornea transplant.

        There's another thing I was reading about where some company out of Minnesota invented some kind of device that keeps organs warm for transplant and keeps them nourished somehow, which provides better outcomes than keeping the organs on ice. The FDA hasn't approved it here so we can't use it, but apparently some European countries are already using it because their approval process is much shorter.

        So we invent nice shit here but the FDA likes to take its time to sort out whether they'll allow it.

    • by Luckyo ( 1726890 )

      No. That is beyond us for now.

      But if we know what specific mutation to look for, we can hopefully identify more donors.

      • Dude, there are literally multiple references in the comment above yours showing it is possible. At least google it before you make a stupid comment. In fact, here is an HIV CRISPR clinical trial you can enroll in now to try to cure yourself of HIV-related dementia: https://clinicaltrials.gov/ct2... [clinicaltrials.gov]

        • by Luckyo ( 1726890 )

          You misunderstand the difference between "possible" and "doable".

          It is possible to have nuclear fusion on planet's surface that would generate power. It is not doable. It is possible to make lithium-air batteries that have energy density comparable to carbohydrates. It's not doable.

          • by Anonymous Coward
            just keep digging...
          • Haha really? If it were "not doable", why is there a clinical trial for doing exactly that? https://clinicaltrials.gov/ct2... [clinicaltrials.gov] Clearly people obviously more qualified than you think otherwise.
            Of course you can keep expanding the meaning of "not doable", beyond any reasonable scope of what sg_oneill meant, to try to "win" this useless pseudonymous argument. Fact is, you tried to squish the idea with a zero-researched "no" and now you're trying to weasel out of being wrong.

            • Re: (Score:3, Interesting)

              by Luckyo ( 1726890 )

              You keep linking the same study that injects T-cells. T-cells do not multiply. Therefore the primary risk of error causing horrific cancerous growths from errors during their creation is absent.

              This is typical for most modern gene therapies. We do not have the necessary error margin in generating cells with modern techniques to generate self replicating cells and have high degree of confidence that tremendous amounts of cells with errors in them will not rapidly become cancerous.

              This is why we still seek do

              • https://newatlas.com/health-we... [newatlas.com]
                And, btw T-cells do multiply. If they didn't, how the heck can they fight infections? Take a fucking intro course on immunology.

                • by Luckyo ( 1726890 )

                  I suggest you take your advice, because you're clearly out of your depth. T-cells are primarily generated in bone marrow. That is why we transplant bone marrow cells to generate T-cells.

                  Same applies to red blood cells from the other study you reference. They are also generated in bone marrow.

                  Again, this is why modern gene therapies focus on those cells. We know that whatever we inject will not go cancerous due to massive amount of errors that are normal with current processes we use to produce them. Look up

                  • T-cells are generated in the bone marrow but they multiply in the blood. Here is a dumbed down explanation for you: https://www.youtube.com/watch?... [youtube.com]

                    Again, how do t-cells fight disease if they can't multiply? Dumbass. Now let me quote you "T-cells do not multiply." How do you propose to weasel out of the factual inaccuracy of that statement?

                    • by Luckyo ( 1726890 )

                      How does cancer work? How is cell multiplication relevant to cancer?

                      Answer those two questions and you'll understand why your red herring is irrelevant.

                    • this has to be one of the saddest attempts at deflection i've ever seen
                  • In summary, just in the last few comments (not counting your other BS on this thread) you made multiple false and misleading anti-gene-therapy assertions that I have disproven and you refuse to retract them:

                    "We do not have the necessary error margin in generating cells with modern techniques to generate self replicating cells and have high degree of confidence that tremendous amounts of cells with errors in them will not rapidly become cancerous." -> disproven by https://newatlas.com/health-we... [newatlas.com]

                    "T-cells

                    • by Luckyo ( 1726890 )

                      1. Fundamental misunderstandings of things like "how cancer works" and "cell multiplication in context of cancer"
                      2. Quote multiple studies without understanding contents, apparently simply looking at titles you found on google.
                      3. And now making random claims on the level of "let's fling random accusations to see if any of it will stick".

                      Ok. Are you done raping that little girl in your basement yet?

        • by Luckyo ( 1726890 )

          I should clarify my other post. We don't know how to edit cells on the level needed for this sort of treatment. We know of potential. We don't know how to implement.

          That is usually the hardest part.

          Trial you link (and many other forms of gene therapies) use fundamentally different techniques that are inherently temporary in nature. The main benefit of approach in the story that it's effectively a permanent cure. Patient is generating cells that lack receptors HIV uses.

          • Dude. Seriously.

            Here is a clinical trial [nejm.org] that is an in vivo therapy to cure amyloidosis, which is a protein mis-folding disease. This injects CRISPR into the body to edit cells inside the body.

            Here is a clinical trial [temple.edu] to use CRISPR to edit out HIV sequences from human DNA. It's an in vivo therapy, meaning not editing cells but injecting CRISPR directly into the body. It has already shown efficacy in primates; this trial is now in human trials.

            CRISPR Therapeutics [crisprtx.com] already has a pipeline of vari

    • Actually, there are two ways to do this with CRISPR, and one is already starting clinical trials.

      People in other comments are giving you yes and no answers not based on any facts. here's the facts.

      There are two types of CRISPR based therapies; and I should caveat that there are other methods of gene editing so CRISPR therapies are falling under a new framework called GET or Gene Editing Therapies. That framework is currently in draft guidance seeking industry comment as of March of this year.

  • ...I miss you, Darrell. Why did you have to stop taking your ARV's?

    At least I got to talk to you a few days before you passed...

    Goodbye, my uncle... The only family that ever loved me unconditionally.

  • by madbrain ( 11432 ) on Thursday July 28, 2022 @12:45AM (#62740290) Homepage Journal

    Slashdot headline proofreaders.

  • by Anonymous Coward

    This is sort of old news, and not surprising that we'd have another patient on the list. If you haven't followed this story over the years, you need to understand why it's not the great breakthrough that leads to a cure. This type of transplant is costly and risky, and not just in the "American health care is broken" kind of costly way. Any developed nation would have a hard time deploying this as a cure, and even if it were not expensive it's risky. These patients all had something *other* than HIV tha

  • "Oldest Patient Yet Cure of HIV After Stem Cell Transplant". Should that be CURED?

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