Doctors Claim HIV-Positive Man Cured by Stem Cell Transplant

[KSig RC]

Originally Posted by AOII Angel

Well, it's not like he had the stem cell transplant to treat his HIV, anyway. He had leukemia. I don't know if anyone would advocate taking a very dangerous treatment like a transplant to treat HIV which for many people is well treated with multi-drug therapy. It's interesting that he had this outcome...not so applicable for the bigger picture.

Drug treatments are relatively effective, sure - but they aren't particularly cost-effective, and if a one-time transplant can eliminate any future risk, it might be preferable over, say, 50 years of continuous drug cocktail, right? (not that the transplant is cheap, either, but I'm sure you see what I'm getting at)

I do agree that it's likely more of a curiosity than anything else at this point, though - particularly as a one-off in a poorly-controlled environment.

[AOII Angel]

Originally Posted by KSig RC

Drug treatments are relatively effective, sure - but they aren't particularly cost-effective, and if a one-time transplant can eliminate any future risk, it might be preferable over, say, 50 years of continuous drug cocktail, right? (not that the transplant is cheap, either, but I'm sure you see what I'm getting at)

I do agree that it's likely more of a curiosity than anything else at this point, though - particularly as a one-off in a poorly-controlled environment.

Transplant can kill you.

[christiangirl]

Originally Posted by AOII Angel

Transplant can kill you.

Taking the wrong drug cocktail can kill you. A bus that hits you in the crosswalk as you leave the HIV clinic can kill you. Et Cetera.

And I agree that this would be awesomely amazing if it were a concrete cure but they def jumped the gun on this one. I'd be interested to see what effect this has on the stem cell research debate if it's "proven" that stem cells can cure HIV.

[AOII Angel]

Originally Posted by christiangirl

Taking the wrong drug cocktail can kill you. A bus that hits you in the crosswalk as you leave the HIV clinic can kill you. Et Cetera.

And I agree that this would be awesomely amazing if it were a concrete cure but they def jumped the gun on this one. I'd be interested to see what effect this has on the stem cell research debate if it's "proven" that stem cells can cure HIV.

Yeah, but in medicine, we don't exactly treat patients with dangerous remedies when less dangerous methods do a good job. Comparing the risk of a bus hitting you as you cross a street to the risks of a stem cell transplant displays a severe lack of knowledge of the risks involved. Taking "the wrong drug cocktail" is not a big risk. These drugs do have side effects, but stem cell transplants are VERY risky. Making light of that just shows your ignorance of the medical issues involved.

[christiangirl]

Originally Posted by AOII Angel

Yeah, but in medicine, we don't exactly treat patients with dangerous remedies when less dangerous methods do a good job. Comparing the risk of a bus hitting you as you cross a street to the risks of a stem cell transplant displays a severe lack of knowledge of the risks involved. Taking "the wrong drug cocktail" is not a big risk. These drugs do have side effects, but stem cell transplants are VERY risky. Making light of that just shows your ignorance of the medical issues involved.

You can call me ignorant but you're being ignorant of my point: Ish happens. People die from all sorts of things so, if a person WANTS the all-or-nothing option, they should be allowed to do so if it's available.

I have personal recollection of a man who was treated with an HIV drug cocktail that DID kill him because it was the wrong combination of drugs for his body. Taking the wrong cocktail is "not a big risk" now but it wasn't always that way. There is reduced risk now because medicine is more advanced and the correct combinations can be pinpointed without so much trial-and-error. Who is to say that, if this option were worth pursuing and the proper research was done, stem cell research wouldn't be so risky for future generations? You speak as though stem cell transplants will always carry the risk they do now but given how many have said more research and testing should have been done before this announcement, I would think it'd be obvious that this thread isn't solely about the possibility of today.

[DrPhil]

Originally Posted by christiangirl

You can call me ignorant but you're being ignorant of my point: Ish happens. People die from all sorts of things so, if a person WANTS the all-or-nothing option, they should be allowed to do so if it's available.

"Ish happens" and "people die from all sorts of things" is a horrible foundation for the legal and regulated practice of medicine.

Originally Posted by christiangirl

I have personal recollection of a man who was treated with an HIV drug cocktail that DID kill him because it was the wrong combination of drugs for his body. Taking the wrong cocktail is "not a big risk" now but it wasn't always that way. There is reduced risk now because medicine is more advanced and the correct combinations can be pinpointed without so much trial-and-error. Who is to say that, if this option were worth pursuing and the proper research was done, stem cell research wouldn't be so risky for future generations? You speak as though stem cell transplants will always carry the risk they do now but given how many have said more research and testing should have been done before this announcement, I would think it'd be obvious that this thread isn't solely about the possibility of today.

LOL. AOIIAngel is in the medical profession and she's just stating the risk of these transplants. She isn't pretending to be able to tell the future. You speak as though anyone definitively knows what these transplants will carry in the future.

These stories reveal exploratory findings and that's why they should hold off until there are more tests. They shouldn't get anxious people all excited over something that might cure HIV or might turn the patient into an HIV infected unicorn. Ya never know and shit happens, right?

[AOII Angel]

Originally Posted by christiangirl

You can call me ignorant but you're being ignorant of my point: Ish happens. People die from all sorts of things so, if a person WANTS the all-or-nothing option, they should be allowed to do so if it's available.

I have personal recollection of a man who was treated with an HIV drug cocktail that DID kill him because it was the wrong combination of drugs for his body. Taking the wrong cocktail is "not a big risk" now but it wasn't always that way. There is reduced risk now because medicine is more advanced and the correct combinations can be pinpointed without so much trial-and-error. Who is to say that, if this option were worth pursuing and the proper research was done, stem cell research wouldn't be so risky for future generations? You speak as though stem cell transplants will always carry the risk they do now but given how many have said more research and testing should have been done before this announcement, I would think it'd be obvious that this thread isn't solely about the possibility of today.

You know I'm a physician, right? When we do informed consent, we don't get to just tell people, "Oh yeah, there are risks in everything...I mean, you could get hit by a bus walking across the road." Yes, there are risks in everything, but the levels of risk are different and have to be quantified. You don't really need to instruct me in why HIV meds are better now than they used to be...I'm quite aware of the medical advances which you so poorly elucidated. Your recollections, however, are incorrect, the man you recall that died from a "wrong combination of drugs for his body" is not an accurate description of HIV therapy. Drugs are NOT prescribed based on anyone's "body type." He may have had side effects from the drugs, but he didn't have the "wrong combination" unless someone just made a gross mistake.

I understand that this is research, but if you'd READ my original post, you'd see that the point I was making was that the consequence of being cured of HIV was really just a side benefit of being treated for leukemia. It was not to primary goal of therapy. While people might think of this as future therapy, IMHO (which I get to have with a little more credibility than you, btw) it is not very likely due to the high risks involved with the treatment. Yeah, it's great if you can cure a disease that kills 25% of people that are infected in 10 years (using assumed stats for emphasis) but kills 50% of patients treated in less than 2 weeks. Those risks are greater than the risk of the disease itself.

[christiangirl]

Originally Posted by AOII Angel

You know I'm a physician, right?

Let me start over--I'm fully aware of your profession and I'm not arguing with you on medical fact nor am I saying I know more than you do because I don't. Nor am I completely without intelligence, so you don't have to lecture me on informed consents--I may not be a doctor but my line of work uses them, too. I know better than to say "here are the risks but you'll die anyway so go for it." If that's how it came across, then I fully retract that. However, I responded to the blanket statement "transplants kill people" which seemed to be your only rationale for why one should use drugs instead of transplants. So, what I was trying to point out (however "crudely") is that "transplants kill people" isn't an argument against the hope of a disease's cure or for further explanation of the option because they also save people once you get them right. So if that's not what you meant then we're on the same page.

For the record, since physicians really do have more credibility on these things than others, you should know it was a physician who made the assertion that the drug cocktail is what killed that man because it was not the right combination for him. If that's not a valid or true reason based on what you know then you would be completely right--that physician made a huge mistake (or he lied).

[KSig RC]

Originally Posted by AOII Angel

Yeah, but in medicine, we don't exactly treat patients with dangerous remedies when less dangerous methods do a good job.

Right, but drugs that manage (rather than eliminate) infections, particularly viral infections that mutate rapidly, are incredibly problematic in their own right, aren't they?

There's no guarantee that the current treatment methods won't lead to an increase in resistant strains (and, to be fair, no guarantee that stem-cell immunity won't be subject to mutation as well) - in fact, it's fairly likely that current best practices for AIDS aren't a long-term solution to the epidemic, right?

I realize there's a balancing point and that the oath you took carries incredible weight, and that it's clearly the best way to look at it from a single-patient standpoint. However, it seems that, from an epidemiological standpoint, the stem-cell method is worth exploring as a much-preferred long-term solution.

This post had many more hyphens that I initially anticipated ... more coffee I guess?

[AOII Angel]

Originally Posted by KSig RC

Right, but drugs that manage (rather than eliminate) infections, particularly viral infections that mutate rapidly, are incredibly problematic in their own right, aren't they?

There's no guarantee that the current treatment methods won't lead to an increase in resistant strains (and, to be fair, no guarantee that stem-cell immunity won't be subject to mutation as well) - in fact, it's fairly likely that current best practices for AIDS aren't a long-term solution to the epidemic, right?

I realize there's a balancing point and that the oath you took carries incredible weight, and that it's clearly the best way to look at it from a single-patient standpoint. However, it seems that, from an epidemiological standpoint, the stem-cell method is worth exploring as a much-preferred long-term solution.

This post had many more hyphens that I initially anticipated ... more coffee I guess?

There are no guarantees in life. Of course we need to keep looking into newer and better treatments for HIV/AIDS. Please read the AMA Morning Brief posted by AOEforme as to why this is not likely to be a longterm solution to the problem of the HIV epidemic. They may put more research into this, but extrapolating a cure for all HIV patients from one patient who was "cured" after receiving treatment for leukemia and incidentally also having his HIV infection cleared from his body is a FAR stretch at this point.

[KSig RC]

Originally Posted by AOII Angel

There are no guarantees in life. Of course we need to keep looking into newer and better treatments for HIV/AIDS. Please read the AMA Morning Brief posted by AOEforme as to why this is not likely to be a longterm solution to the problem of the HIV epidemic. They may put more research into this, but extrapolating a cure for all HIV patients from one patient who was "cured" after receiving treatment for leukemia and incidentally also having his HIV infection cleared from his body is a FAR stretch at this point.

... which is why my initial post labeled this a "curiosity" rather than anything to hitch wagons to.

That doesn't change the implications though.