2nd person cured of hiv?

[loneranger]

Hey guys

Came across this article online this evening claiming that a 2nd person has now been cured of hiv. The piece is not very well written and I'm unclear as to the exact details of this supposed 'cure' but it looks like he underwent the same procedure as Timothy Brown. Anyone else heard about this? Link below

http://scienceray.com/biology/cure-for-aids-discovered-in-germany/

[Sweet_C]

I hadn't heard of it, but I doubt this second guy was "cured".  The only reason the first guy got the treatment was because he had leukemia.  This guy probably just got on meds and is now undetectable. 

[loneranger]

Probably, but it's interesting that they quote the Timothy Brown case and mention a stem cell therapy. Would like to know who their source is!

[Rev. Moon]

Doesn't look like a very reliable, peer-reviewed type of website. 

[leatherman]

I have three issues with this

Two patients in as many months have been cured of the HIV virus, better known as the AIDS virus.

1) just what does "in as many months" mean? The Berlin patient's treatment happened years ago. It is misleading and incorrect to say that multiple patients have been cured of HIV within months of each other.

You may remember Richthofen was the center of controversy when it was revealed that the standout point guard  had played nearly an entire season with the virus unbeknownced to opponents and team mates alike

2) just who is "Stephen Richthofen"? a google search only turns up this name linked to "scienceray"

3) Actually a better description is to say that Timothy Brown's HIV was eradicated not "cured".  Calling chemo, radiation, leukemia, several stem cell transplants and all the resulting health issues (neurological side effects which left him forgetful, temporarily blind, unable to walk and to talk normally and with a change in personality [link]) a "cure" totally glosses over the extreme risk of death in all those procedures and the extreme luck T. Brown had in surviving. Also calling these procedures a "cure" is also very misleading to the general public at a time when health care funding and the ADAP funding of several state are in dire straits while HIV infections continue.

[Sweet_C]

3) Actually a better description is to say that Timothy Brown's HIV was eradicated not "cured".  Calling chemo, radiation, leukemia, several stem cell transplants and all the resulting health issues (neurological side effects which left him forgetful, temporarily blind, unable to walk and to talk normally and with a change in personality [link]) a "cure" totally glosses over the extreme risk of death in all those procedures and the extreme luck T. Brown had in surviving. Also calling these procedures a "cure" is also very misleading to the general public at a time when health care funding and the ADAP funding of several state are in dire straits while HIV infections continue.

Wow, the press really left out a lot of key details about Timonthy Brown's cure!  It's too bad that there's been so much focus on this cure rather than on the amazing successes of the treatment out there these days.  The only  bad thing about the drug is making sure you can afford them here in the U.S.  I can't even watch the news anymore because it seems that both Republicans and Democrats are banding together to cut funding to the people who need it most.  It's so frightening. 

[next2u]

yeah, the article doesn't seem to hold any water. there are many questions about the validity of the article (sources, supporting documents, etc...) and if this were true in any way shape or form it would have made the news in a major way. plus there is no press anywhere about this.

the website seems more like a rogue blog for quasi science than anything else. don't get your hopes up based on this.

best,
d

[leatherman]

Wow, the press really left out a lot of key details about Timonthy Brown's cure!  It's too bad that there's been so much focus on this cure rather than on the amazing successes of the treatment out there these days.  The only  bad thing about the drug is making sure you can afford them here in the U.S.  I can't even watch the news anymore because it seems that both Republicans and Democrats are banding together to cut funding to the people who need it most.

it's that same bad press that makes Truvada out to sound like the best prophylaxis out there when it's really only about 44% effective at best.

sorry for going a bit off topic with this one; but these reports about a "cure" and "preventative med" really get my goat. The science isn't reported properly and the perception that is put out there is wrong; and those wrong perceptions influence whether officials believe HIV issues need to be funded. (why fund ADAP when there's a "cure" and a med that can be taken to prevent HIV infection? )

[Assurbanipal]

it's that same bad press that makes Truvada out to sound like the best prophylaxis out there when it's really only about 44% effective at best.

Might you perhaps be misremembering the results of the Truvada prophylaxis study?  It was 44% effective on average, including in the average people who didn't take it consistently.  The results for people who took it daily were 73% effectiveness.  Presumably the "at best " number would be north of 73%.

http://www.aidsmeds.com/articles/hiv_prep_iprex_2042_19471.shtml

The scienceray article is interesting, but it doesn't seem to be verified elsewhere.

[leatherman]

It was 44% effective on average, including in the average people who didn't take it consistently.  The results for people who took it daily were 73% effectiveness.  Presumably the "at best " number would be north of 73%.

we have a difference of opinion in my usage of "at best". I should have qualified it as "at best for the average person" so as to not confuse the issue with the much smaller "at best" upper range of the reported effectiveness.

I do remember the inital annoucement of the study and also it's further conclusions from the ongoing study. Starting with a basis of 2500 mainly "gay" sex-workers in Peru and Ecuador, actually the 73% effectiveness only happened with a small portion of the study group and those people also received counseling and monitoring, received prevention and education training, and were given condoms also. Most conclusions reported from the study, which eventually went on to include patients from Thailand, South Africa and the US (appr 400 MSM from Boston I believe), report the findings as a 44% reduction, not the high end 73%.

Even the CDC conclusions are of 44% not 73%. "Enrollment in the PrEP arm was associated with a 44% reduction in HIV acquisition" - 1/28/2011 CDC report from MMWR "Interim Guidance: Preexposure Prophylaxis for the Prevention of HIV Infection in Men Who Have Sex with Men" http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6003a1.htm?s_cid=mm6003a1_w

So instead of looking at those few in the study who seemed to receive the most effectiveness from the medication (which is not verifiable because of the influences of the extra counseling, education, monitoring and condoms), if we look at the average person in the study, "at best" those average people only received a 44% increased protection. At $35 a day for the Truvada, that's a lot of potential side effects and a lot of money (will insurance even pay for such a usage of Truvada?) compared to the incredible cheap and easy (and only used when needed) effectiveness of condoms.

Currently AIDS Healthcare Foundation is running a campaign against FDA approval of Truvada for PrEP
http://eon.businesswire.com/news/eon/20110309006431/en/Gilead-Sciences/Truvada/'pre-exposure-prophylaxis'
http://www.aidshealth.org/advocacy-policy/current-issues/prep-sign-on.html

[denb45]

Hey guys

Came across this article online this evening claiming that a 2nd person has now been cured of hiv. The piece is not very well written and I'm unclear as to the exact details of this supposed 'cure' but it looks like he underwent the same procedure as Timothy Brown. Anyone else heard about this? Link below

http://scienceray.com/biology/cure-for-aids-discovered-in-germany/

NON SENSE, we all know that to date there is NO cure for AIDS 

[mecch]

Wouldnt that be the final injustice:  AIDS cured and the world shrugs its shoulders.

Reducing the experience of the Berlin Patient to the word "cured" is a misnomer.

I think members of this forum should chose their words wisely, and evaluate their information sources.  He was cured, but put through the wringer, and the method is not "the cure".

[Assurbanipal]

... actually the 73% effectiveness only happened with a small portion of the study group and those people also received counseling and monitoring, received prevention and education training, and were given condoms also.

 So instead of looking at those few in the study who seemed to receive the most effectiveness from the medication (which is not verifiable because of the influences of the extra counseling, education, monitoring and condoms), if we look at the average person in the study, "at best" those average people only received a 44% increased protection....

The study report (which you linked to) does not support the inference that participants with better results got them because they received "extra" counseling.  Describing the provision for all participants enrolled in the study: "Participants were seen every 4 weeks for an interview, HIV testing, risk-reduction and PrEP medication adherence counseling, pill count, and dispensing of pills and condoms."

we have a difference of opinion in my usage of "at best". I should have qualified it as "at best for the average person" so as to not confuse the issue with the much smaller "at best" upper range of the reported effectiveness.

...um... yes...  and still do.  When a study reports on different groups and someone says "at best" it is generally anticipated that they are talking about...well... the reported result for the best group.


There is a second alternative when a study reports results as a sample and gives a range around the results to indicate that the results are expected to be in that range....a confidence interval for its results. If one were to read the part of the study that says "Enrollment in the PrEP arm was associated with a 44% reduction in HIV acquisition (95% confidence interval [CI] = 15%--63%)" then it would also be plausible to read a statement that for the average person who was enrolled in the study the results showed , at best, a 63% reduction in risk.

As to what drove results of the study it is clearly whether participants were getting enough of the drug into them.


"Reduction in risk for HIV acquisition was 21% among participants at visits with <90% adherence (CI = -31%--52%) and 73% at visits with ≥90% adherence (CI = 41%--88%). Among those randomly assigned to the TDF/FTC arm, drug level testing was performed for all HIV seroconverters and a matched subset of participants who remained uninfected; a 92% reduction in risk for HIV acquisition (CI = 40%--99%) was found in participants with detectable levels of TDF/FTC versus those with no drug detected"


AHF and others have suggested that given the fact so few succeeded in taking the right amount of drug, caution is a good idea.  That is different, however, from a license to misrepresent the numbers or the counseling provided to enrolled participants.


I fear we have moved into hijack territory, so if you care to extend this discussion perhaps we should set up a new thread focused on PreP...