Man appears free of HIV after stem cell transplant
 

A 42-year-old HIV patient with leukemia appears to have no detectable HIV in his blood and no symptoms after a stem cell transplant from a donor carrying a gene mutation that confers natural resistance to the virus that causes AIDS, according to a report published Wednesday in the New England Journal of Medicine. The patient underwent a stem cell transplant and since, has not tested positive for HIV in his blood. The patient underwent a stem cell transplant and since, has not tested positive for HIV in his blood.

"The patient is fine," said Dr. Gero Hutter of Charite Universitatsmedizin Berlin in Germany. "Today, two years after his transplantation, he is still without any signs of HIV disease and without antiretroviral medication."

The case was first reported in November, and the new report is the first official publication of the case in a medical journal. Hutter and a team of medical professionals performed the stem cell transplant on the patient, an American living in Germany, to treat the man's leukemia, not the HIV itself.

However, the team deliberately chose a compatible donor who has a naturally occurring gene mutation that confers resistance to HIV. The mutation cripples a receptor known as CCR5, which is normally found on the surface of T cells, the type of immune system cells attacked by HIV.

http://www.cnn.com/2009/HEALTH/02/11...ell/index.html

Hmmm... I'm skeptical about the HIV + "opportunistic" illness = AIDS concept because I'm a conspiracy theorist and I think the drug companies/government are making us sick to keep money pouring into the pockets of certain people.

However, I'm absolutely intrigued at the possibility of eradicating viruses in general through the use of stem cells from people who are immune to various things. That would be AMAZING!

wooooow

Until some Frenchman screws a monkey and introduces "super-AIDS" to the population.

I got to this part, then died.

I don't know what you mean by that. AIDS patients clearly get infections with pathogens that people with normal immune systems do not, including HIV patients with normal T cell levels. Trust me, I've seen a lot of these patients. There is very CLEAR science behind this.

IMHO, the only reason why this interesting is that the data was published in NEJM. It is not often they publish junk these days... Apparently, the receptor CCR5 delta32 was from a homozygous donor. So the HIV infected man was the recipient of that homozygous donor (a 1:3 chance that would ever happen).

However, the HIV infected recipient ALSO has another form of HIV called X4. It is unknown what will happen.

What is interesting is that all the WBC's from the donor repopulated a HIV recipient. It is possible, but not proven until the work was actually done, then it is unknown about the prognosis.

Dr. Levy at UCSF says this will NOT be a normal treatment in the US... Too many questions and I wouldn't want to write that human subject's IRB... But that'll be me...

Yay, Science!

Like pneumonia which, by itself, is not AIDS? I don't believe a lot of the "facts" that are permitted to be spread by the media. I'm not a scientist, so I don't necessarily understand all the science behind AIDS research, but that's not what I'm talking about anyway.

What do you mean "until"? :p

Pneumonia in and of itself is NOT AIDS defining. Pneumonia with fungal types not seen in immunocompetent patients certainly is AIDS defining if the patient already has HIV status. Without a compromised immune system, every human can fight off these pathogens. I don't understand all these conspiracy theories involving medicine. We really do want people to get better, we really don't just prescribe drugs to get the free pens and we don't make up diseases just to keep pharmaceutical companies in business.

Do you happen to know if there's been a study done to test the incidence of fungal pneumonia in non-HIV-positive patients vs. HIV-postitive patients who are not being treated for HIV/AIDS vs. HIV-positive patients who are being treated for HIV/AIDS? I'd be interested in those results.

Anyway, I am VERY skeptical of western medicine though my life has been saved more than once by modern medical advances. I do my best to stay away from doctors and medicine.

Yes...they have studied all of this! Deaths from AIDS are actually due to these infections and opportunistic cancers, not due to the virus itself. Treatment for HIV has actually been a huge success. Being diagnosed is no longer a death sentence. Medications are much better and less likely to cause major side effects like pancreatitis. People with HIV now are treated like patients with chronic disease, not patients who are terminal.

As for staying away from doctors and medicine, a dose of preventative medicine goes a long way!

This is true, yet very unfortunate. I work for a Ryan White CARE Act funded organization and I can say that people ARE still dying of AIDS out here. :(

well you know what they say: "There is more money in the bandage than there is in the cure."

Oh, I'm sure there are a lot of people who are still dying. Not everyone has access to these drugs, not everyone will take the drugs and some people still do have severe side effects that make it impossible to take the drugs. Hopefully, we will be able to make these meds accessible to anyone who needs them.

It's also worth pointing out that different people react differently to the same drugs. You may respond very well and have no problems from the HIV while on retrovirals, while I could show no improvement.

That's very unlikely, however. The vast majority of patients who take these drugs control their HIV viral loads very well.

While the drugs may overall tend to be very effective, any drug can be a degree of effectiveness based on the patient. Some drug therapies are obviously more pronounced in this effect (steroids for sarcoidosis comes to mind), but it still happens with all drugs. Specifically with AIDS, because many patients take it for such a long time, the virus can develop resistances to the therapies and become significantly less effective.

While, modern medicine has made great strides especially over the ~20 years of HAART, HIV/AIDS patients do die over time, albeit, at later ages they normally would and possibly something unrelated to their infection... Please let me know if I am wrong...

It is my understanding that they die from total organ failure, at one time. HAART does cause a lipoatrophy as well as left ventricular cardiomyopathy. So that's rough 2-3 vital organs involved: pancreas, heart and liver (and/or kidney).

While we do not see that many people dying from a painful death from full-blown AIDS symptoms, such as the Kaposi's Sarcoma or the Pneumocystis carnii, at rates seen in the mid-1980's, these souls actually do die from shorten lifespan with chronic diseases of cardiovascular aging. And very few odd cancers, like astroglialomas or hepatocarcinomas that normally happens in rodents...

While that does not negate the treatment with HAARTs and they are beneficial for treatments, there does have to be disclosure with these drugs, they are NOT aspirins or Tylenols--they are multi-functional pharmas, protease inhibitors, anti-retrovirucides, etc...

Most lay people really do not get that fact, making it a PART of a public health issue rather than a physician ONLY issue...

How do I know as a former R21 NIH awarded research scientist, hospice caregiving is NOT a joke...

Just trying to help...

The causes of death in HIV/AIDS has evolved over time significantly. Lifespan after diagnosis can be many decades now. I agree that these drugs are not totally benign drugs. Lipoatrophy, pancreatitis are common side effects, though the newer drugs are less likely to cause these side effects. One of the major problems with the earlier drugs has been improved with the newer drugs...fewer pills fewer times a day. This also decreases the likelihood of multidrug resistance since patients are less likely to miss their doses. Sure there are still problems, but therapy is fairly benign for the average patient. This allows the patients to live normal lives. Jumping to stem cell transplants, however, will result in costly and deadly results.
Hopefully with more time, researchers will continue to find drugs that suppress the virus with even fewer side effects. All in all, there have been great leaps in treatment since the 80s.

I agree with you, but before these therapies, patients didn't live long enough for that to happen. It's hard to fault a drug that gives the patient so many extra years to actually develop a resistance. Yes, drugs have varying levels of effectiveness depending on the specific genetics of the patient and virus, but all in all, the drugs are VERY effective.

Thank you for your explanation.

Laypeople do think that by the time they get "normal" CD4+ counts, and low HIV titers, they are as healthy as an "ox" like a normal person. The reality is, that is how the "cocktails" keep you safe from degenerating with all kinds of crazy diseases that once predominated when we did not have the HAART...

The patients live probably up until their 60's. Maybe there are some longitudinal studies, I haven't seen them, myself. It doesn't mean they don't exist, but it would be nice to know the efficacy of the HAART longitudinally.

I agree, we need to "slow our roll" on stem transplant if there is true correction against HIV. Something tells me the data need more interrogation... Especially in light of quite a bit of scientific misconduct that is going on these days. I would wait to see correction in primates before I recommend a human trial...

That's just my opinion... Feel free to take it or leave it.