Berlin patient 's doctor medical account of the case

[eric48]

Berlin patient 'doctor medical account

there has been a lot of second and third hand information on the Berlin patient.

As his case gets more publicity, it is of interest to note that the doctor (Gero Hütter) who allegedly cured him has recently published a medical account of the case.

Reference can be found here.

http://www.ncbi.nlm.nih.gov/pubmed/21552772

The article is copyrighted. This is too bad, I wished it was made available to the largest audience in order to avoid false hopes as well as false information.

Eradication of HIV by Transplantation of CCR5-Deficient Hematopoietic Stem Cells

by  Gero Hütter and Susanne Ganepola

Published May 5, 2011

abstract:

Today, 30 years after the onset of the HIV pandemic, although treatment strategies have considerably improved, there is still no cure for the disease. Recently, we described a successful hematopoietic stem cell transplantation in an HIV-1–infected patient, transferring donor-derived cells with a natural resistance against HIV infection. These hematopoietic stem cells engrafted, proliferated, and differentiated into mature myeloid and lymphoid cells. To date, the patient has not required any antiretroviral treatment, more than 4 years after allogeneic transplantation. In the analysis of peripheral blood cells and different tissue samples, including gut, liver, and brain, no viral load or proviral DNA could be detected. Our report raises the hope for further targeted treatment strategies against HIV and represents a successful personalized treatment with allogeneic stem cells carrying a beneficial gene. However, this case has ignited a controversy regarding the question of whether this patient has achieved complete eradication of HIV or not. Here we give an update on open questions, unsolved aspects, and clinical consequences concerning this unique case.


Of note:

- the article provides a detailed CD4 and VL chart/timeline for the patient from : June 06 to Jan 11
it is very interesting to note that CD4 recovery was slow or moderate for the year 1 but a bit more sustained from then on to reach 800 by year 3

- the patient had a cancer relapse and therefore had 2 allogenic transplantations

- it should be noted that this account clearly states that the patient was originally Dual tropic and not CCR5-only (as I think I may have read elsewhere)

(Before receiving the stem cell transplant, the patient’s HIV-1 population comprised a proportion of 2.9% X4 or dual-tropic variants.)

The auther discusses a list of OPEN QUESTIONS
Why there is no escape of X4 quasispecies?
Is there something special about this patient?
What was the role of the transplantation procedure?
Is the patient functionally cured?
Is the patient sterilizing cured?
Is there a Graft vs. HIV effect?
Why was this procedure not repeated in other patients?

and offers their CONCLUSIONS
The combination of antiretroviral medication provides a long-term suppression of HIV-1 replication below the level of detection in the majority of patients. However, even sustained and efficient medication does not fully restore health and new strategies to avoid HIV-associated complications are mandatory.

Therefore, the combination of stem cell and gene-based therapies has been proposed as a long-lived alternative to antiretroviral therapy.
The case of the first successful allogeneic HSCT with CCR5-depleted stem cells in a patient with HIV infection has initiated a run towards the development of new gene therapy strategies against this disease. It is not unlikely that during the next decades, HIV treatment will enter a new level of efficiency and will move us one step closer towards a cure.


The article can be purchased for about $ 25

the same author also published 3 other articles on the same subject:
http://www.ncbi.nlm.nih.gov/pubmed?term=%22H%C3%BCtter%20G%22[Author]

Enjoy !

Eric