Quantcast

Subscribe to:
POZ magazine
Newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr Instagram
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
October 25, 2014, 02:10:19 PM

Login with username, password and session length


Members
  • Total Members: 23786
  • Latest: rvarona
Stats
  • Total Posts: 643562
  • Total Topics: 48968
  • Online Today: 191
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Bone marrow transplant cures hiv infection  (Read 23464 times)

0 Members and 1 Guest are viewing this topic.

Offline freewillie99

  • Member
  • Posts: 311
Bone marrow transplant cures hiv infection
« on: November 07, 2008, 08:57:02 AM »
I'm sure I've seen this story on here before, but here's an update from today's WSJ.  Obviously getting a bone marrow transplant in order to eradicate HIV is unrealistic to say the least, but it looks like this may indicate gene therapy approaches have some merit.

http://online.wsj.com/article/SB122602394113507555.html?mod=googlenews_wsj
Beware Romanians bearing strange gifts

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #1 on: November 07, 2008, 11:24:10 AM »
Since the beginning, got lot of hopes in the approach of the Dr Hutter and on the VRX496.

Finally, I should stop listening to the pessimist, despite my respect for them.


Just a fantastic news  !


Offline ronaldinho

  • Member
  • Posts: 79
Re: German transplant operation eradicates HIV
« Reply #2 on: November 07, 2008, 01:27:08 PM »
So, the next step would be to find a way to alter genetically the immune system of an HIV+ patient without having to recur to a bone marrow transplant. Hope scientists can work this out.

Offline HALOO

  • Member
  • Posts: 60
Re: German transplant operation eradicates HIV
« Reply #3 on: November 07, 2008, 03:49:41 PM »
Have a Question, Do you test Postive or Negative??

Offline HALOO

  • Member
  • Posts: 60
Re: German transplant operation eradicates HIV
« Reply #4 on: November 07, 2008, 03:53:38 PM »
I am sorry, I mean he(the Patient)

Offline freewillie99

  • Member
  • Posts: 311
Re: German transplant operation eradicates HIV
« Reply #5 on: November 07, 2008, 04:15:05 PM »
So, the next step would be to find a way to alter genetically the immune system of an HIV+ patient without having to recur to a bone marrow transplant. Hope scientists can work this out.

ronaldinho:

Correct.  Here's the latest about the work being done at California's "City of Hope" that is referenced in the WSJ article.

http://www.abnnewswire.net/press/en/58361/Benitec_Limited_ASX:BLT_City_of_Hope_Human_Trial_Update.html
Beware Romanians bearing strange gifts

Offline freewillie99

  • Member
  • Posts: 311
Re: German transplant operation eradicates HIV
« Reply #6 on: November 08, 2008, 08:56:59 AM »
Here's another article which was posted here a couple months back for those that are new or just didn't see it.  It's along the same lines as the Benitec project at City of Hope and somewhat related to the work being done by Virxys in Maryland as well as on the patient in Germany referenced above.  My point here is not necessarily that any of this is going to result in imminent treatments, but to show that there is promising work being done on the gene therapy front and reason for optimism.

http://www.webmd.com/hiv-aids/news/20080808/gene-silencing-may-stop-aids-virus?page=2
Beware Romanians bearing strange gifts

Offline leit

  • Member
  • Posts: 236
Re: German transplant operation eradicates HIV
« Reply #7 on: November 13, 2008, 06:46:14 PM »
Very probably, we will soon know every detail: "Dr. Hütter is writing an article for a specialized medical journal in order to describe and make his therapy public in every detail".

http://www.repubblica.it/2008/11/sezioni/scienza_e_tecnologia/aids-guarito/aids-guarito/aids-guarito.html - last paragraph
« Last Edit: November 13, 2008, 06:55:44 PM by leit »

Offline MYSTERY

  • Member
  • Posts: 186
Re: German transplant operation eradicates HIV
« Reply #8 on: November 13, 2008, 08:31:29 PM »
 
 Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, said those tests have probably not been extensive enough.

"A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Badley said. This isn't the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported. Huetter's patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV.

As Huetter — who is a hematologist, not an HIV specialist — prepared to treat the patient's leukemia with a bone marrow transplant, he recalled that some people carry a genetic mutation that seems to make them resistant to HIV infection. If the mutation, called Delta 32, is inherited from both parents, it prevents HIV from attaching itself to cells by blocking CCR5, a receptor that acts as a kind of gateway. "I read it in 1996, coincidentally," Huetter told reporters at the medical school. "I remembered it and thought it might work."

Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient's marrow type. Out of a pool of 80 suitable donors, the 61st person tested carried the proper mutation.

Before the transplant, the patient endured powerful drugs and radiation to kill off his own infected bone marrow cells and disable his immune system — a treatment fatal to between 20 and 30 percent of recipients. He was also taken off the potent drugs used to treat his AIDS. Huetter's team feared that the drugs might interfere with the new marrow cells' survival. They risked lowering his defenses in the hopes that the new, mutated cells would reject the virus on their own.

Anthony Fauci, director of the National Institute of Allergy and Infections Diseases in the U.S., said the procedure was too costly and too dangerous to employ as a firstline cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV. "It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate," Fauci said.

David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, said gene therapy as cheap and effective as current drug treatments is in very early stages of development. "That's a long way down the line because there may be other negative things that go with that mutation that we don't know about."

Even for the patient in Berlin, the lack of a clear understanding of exactly why his AIDS has disappeared means his future is far from certain. "The virus is wily," Huetter said. "There could always be a resurgence."


« Last Edit: November 13, 2008, 08:34:39 PM by MYSTERY »
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline freewillie99

  • Member
  • Posts: 311
Re: German transplant operation eradicates HIV
« Reply #9 on: November 14, 2008, 08:38:35 AM »
Leit: Thanks for the link to the article.  Too bad I don't read Spanish...

Re: Dr. Andrew Badley of the Mayo Clinic's quote in the above article, sounds like a case of "not invented here" sour grapes.  Nevertheless, I look forward to extensive peer review and exploration of this exciting (and presumably) groundbreaking case.

edit: or is it in Italian?

« Last Edit: November 14, 2008, 08:43:20 AM by freewillie99 »
Beware Romanians bearing strange gifts

Offline georgep77

  • Member
  • Posts: 148
Re: German transplant operation eradicates HIV
« Reply #10 on: November 14, 2008, 09:58:30 AM »
Yes freewillie99, is in Italian.

Hopefully the article can be translated to english, using google translator

http://www.google.ca/language_tools?hl=en

                                                     :)
« Last Edit: November 14, 2008, 10:05:32 AM by georgep77 »
Come on Sangamo,  Geovax,  Bionor immuno, ...Make us happy !!!
+ 2008

Offline tash08

  • Member
  • Posts: 86
Re: German transplant operation eradicates HIV
« Reply #11 on: November 14, 2008, 06:53:19 PM »
For example, Dr. Irvin S. Y. Chen, director of the AIDS Institute at U.C.L.A. , is working on using RNA “hairpin scissors” to cut out the bits of genetic material in blood stem cells that code for the receptors. The concept is working in monkeys, he said. Eventually, he hopes, it will be possible to inject them into humans after wiping out only part of the immune system with drugs. “I think that would carry no risk of death,” he said.

http://www.nytimes.com/2008/11/14/health/14hiv.html?_r=1&oref=slogin

01/04/06-HIV-
03/09/06-HIV+
05/07-Atripla
04/01/10 CD4-681, VL-UD
07/10/10 CD4-450, VL-UD
10/10/10 CD4-473, VL-UD
01/21/11 cd4-522, VL-UD
05/02/11 CD4-638, VL-UD <20 copies Hell yeah!
08/3/12 CD4-806, VL-UD

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #12 on: November 16, 2008, 04:15:28 AM »
Either a cure or a path to it

Im volunteer to do it and will ask to be treated also.
no matter if it fails for 20-30%

Otherwise video about the subject
http://www.youtube.com/watch?v=0ZNtePGaJWw

Offline Miss Philicia

  • Member
  • Posts: 24,227
  • celebrity poster, faker & poser
Re: German transplant operation eradicates HIV
« Reply #13 on: November 16, 2008, 11:23:57 AM »
I'd rather take a handful of pills every day for decades than volunteer for something with a 30% chance of failure.
"I’ve slept with enough men to know that I’m not gay"

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #14 on: November 16, 2008, 11:34:58 AM »
Just wondering why they haven't talk about his cd4, cd4%, fbc, etc

Offline OneTampa

  • Member
  • Posts: 2,274
  • "Butterflies are free."
Re: German transplant operation eradicates HIV
« Reply #15 on: November 16, 2008, 04:28:30 PM »
This is a very interesting development.  I was curious though when it was reported on Fox news the other night and only given about 15 seconds.  There was no "breaking" news or interview with the doctor.  That made me a bit suspicious.  For one thing, if this type of information doesn't deserve the "breaking news" crawl, I don't know what does.
"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."

Offline ronaldinho

  • Member
  • Posts: 79
Re: German transplant operation eradicates HIV
« Reply #16 on: November 16, 2008, 09:03:51 PM »
This is a very interesting development.  I was curious though when it was reported on Fox news the other night and only given about 15 seconds.  There was no "breaking" news or interview with the doctor.  That made me a bit suspicious.  For one thing, if this type of information doesn't deserve the "breaking news" crawl, I don't know what does.

The absence of press highlights also made me wonder. This story has going on for almost 2 years with little press coverage. Maybe they wanna be sure that the outcome of this transplant was not due to an extraordinary rare conjonction of circumstances, so they will wait for another HIV + patients who are in need of bone marrow transplant to undergo the same procedure, so they can be sure that the procedure itself is capable of eradicating HIV, regardless of some other unknown specific genetics of donor and receptor that might have played a role in this case.

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #17 on: November 17, 2008, 01:51:38 AM »
There are a huge amount of website covering this event.
Some are scientifics website, others are websites from newspaper, etc

Just take a look for e.g. here and see how many websites are referenced accross mutliples pages

Offline freewillie99

  • Member
  • Posts: 311
Re: German transplant operation eradicates HIV
« Reply #18 on: November 17, 2008, 10:30:42 AM »
I was curious though when it was reported on Fox news the other night and only given about 15 seconds.  There was no "breaking" news or interview with the doctor.  That made me a bit suspicious. 

Hmmm...OneTampa, please consider the source.  Fox News?  The home of Sean Hannity, Bill O'Reilly, and the legion of Barbie newscasters?  Fox thinks Sarah Palin was highly qualified to be President.  Enough said.  Somehow I don't see them being overly concerned about anything related to gays or HIV unless it's negative.  Far be it for me to tell you what to do, but you might consider alternative sources of information.
Beware Romanians bearing strange gifts

Offline David Evans

  • member
  • Member
  • Posts: 97
Re: German transplant operation eradicates HIV
« Reply #19 on: November 17, 2008, 02:57:57 PM »
Hello everyone,

I wrote an article about this for AIDSmeds earlier this year: http://www.aidsmeds.com/articles/hiv_aids_stemcell_2042_14199.shtml.

I interviewed Huetter for the article and talked to a number of other people at the time, and you're right that general awareness of the transplant was fairly low. It is possible that Huetter's using the "C" word a bit incautiously, but he and the transplant patient are legit, and there's a decent chance that a functional cure may have been acheived.

Experts were mixed about how relevant this would be for the average person with HIV, and everyone at that time pointed at gene therapy. That's some years off in the future, but it's hopeful.

David

Offline OneTampa

  • Member
  • Posts: 2,274
  • "Butterflies are free."
Re: German transplant operation eradicates HIV
« Reply #20 on: November 17, 2008, 06:28:15 PM »
Freewillie99, oh yes.  I am quite cautious about Ms. Fox.  I was in DC and watched the local news broadcast.  I will check out other sources though.
"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #21 on: November 18, 2008, 01:57:17 AM »
What surprise me a bit about this patient result, is that he is not the only HIV poz guy who have been through a chemio.

So why this result haven't been obtained earlier already ?

Is it only due to the use of homozygote CCR5 delta 32, is it due to a different chemio protocol, to the chance, etc ?

Why no more details have been published, in particular, the cd4 and fbc, is the patient virus a R5 only or is it mix, etc

This news contains little info to support the hope it provide

Offline leit

  • Member
  • Posts: 236
Re: German transplant operation eradicates HIV
« Reply #22 on: November 18, 2008, 08:26:28 AM »
Why no more details have been published, in particular, the cd4 and fbc, is the patient virus a R5 only or is it mix, etc

Don't expect from the WSJ or Fox News what they can't give, "John2038", and see above: "Dr. Hütter is writing an article for a specialized medical journal in order to describe and make his therapy public in every detail".

Moreover, after the recent amfAR meeting, Dr. Hütter has promised to send some biological samples of his patient's to U.S. researchers (Dr. Ho and others - sorry but I don't manage to find the source where I've read that), so they can study them too.
« Last Edit: November 18, 2008, 08:31:20 AM by leit »

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: German transplant operation eradicates HIV
« Reply #23 on: November 18, 2008, 12:25:14 PM »
What surprise me a bit about this patient result, is that he is not the only HIV poz guy who have been through a chemio.

So why this result haven't been obtained earlier already ?

Actually, the WSJ article suggested that this was the second patient to have been potentially "cured" of HIV, --  with a previous patient who did not survive the cancer treatment but did not show presence of HIV anymore. If a rare genetic immunity is required in the donor cells it isn't really surprising that this would be the first to survive both. While chemo is pretty common, bone marrow transplants aren't that frequent....  and doctors tend to prefer to do transplants on people who have the greatest chance of living after the operation ...
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #24 on: November 18, 2008, 12:28:17 PM »
Sure leit, but they could have at least publish some data last Feb (CROI 2008)
It's the second announcement (300 and 600 days) without detailed publications.

Anyway, I still think that it's either the cure or a path to it.

I also think that all those scientist who are working since years for a solution to HIV are looser.
The approach of the Dr Hutter is so obvious (and many others approach are) but big pharma just prefer produce pills able to almost keep chronic this disease.

I know it's not fair to talk like that, but an immune system reset was one of my question 1 year ago.
If I can ask myself about such approach, any body can.
Same with starting HAART earlier and so many others things I just forget.

It seems that for all these people and most patient, be cautious is the only way of thinking.
For them, nothing is obvious in medicine, even what is logical.
It make sense generally speaking (the body is not a computer), but thinking about resetting the immune system should have been tried much earlier.
« Last Edit: November 18, 2008, 12:31:22 PM by John2038 »

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #25 on: November 19, 2008, 12:44:15 PM »
Just this nice short summary on what have been said so far about this subject.

Several newspapers recently profiled the case of an HIV-positive person who underwent a bone marrow transplant to treat leukemia and who has had undetectable HIV viral loads for almost two years. For the procedure -- performed by German hematologist Gero Hutter of Berlin's Charite Medical University on a 42-year-old American living in the city -- the patient's bone marrow cells were replaced with those from a donor with a naturally occurring gene mutation that provides immunity to almost all strains of HIV by preventing the CCR5 molecule from appearing on the surface of cells. Prior to the transplant, Hutter administered a standard regimen of drugs and radiation to kill the patient's bone marrow cells and many immune-system cells, which may have helped the treatment succeed because the procedure killed many cells that harbor HIV, according to an earlier Wall Street Journal report. Transplant specialists then ordered the patient to stop taking his antiretroviral drugs when they transfused the donor cells because they were concerned that the drugs might undermine the cells' ability to survive in their new host. Although the plan was to resume the antiretroviral regimen once HIV re-emerged in the patient's blood, more than 600 days later, standard tests have not detected HIV in his blood, or in brain and rectal tissues where the virus often hides (Kaiser Daily HIV/AIDS Report, 11/7). Summaries appear below.

    * New York Times: According to some U.S. researchers, the treatment has "novel medical implications" but will ultimately "be of little immediate use" in treating HIV/AIDS, the Times reports. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, said the treatment is "very nice" and "not even surprising," but "just off the table of practicality." The Times reports that many researchers said the treatment is "unthinkable" for the millions of people living with HIV/AIDS in Africa and "impractical even for insured patients in top research hospitals." The patient had leukemia in addition to AIDS, which warranted the high risk of a blood stem cell transplant, but 10% to 30% of people who receive bone marrow transplants die. According to the Times, the odds of locating a donor who is both a good tissue match for the patient and has the CCR5 genetic mutation are "extremely small." Robert Gallo, director of the Institute of Human Virology at the University of Maryland School of Medicine, said, "Frankly, I'd rather take" antiretroviral drugs. However, the Times reports that the success reported for this patient is "evidence that a long-dreamed-of therapy for AIDS -- injecting stem cells that have been genetically reengineered with the mutation -- might work" (McNeil, New York Times, 11/14).

    * AP/Google.com: Although researchers and the physicians involved in the case caution that it "might be no more than a fluke, others say it may inspire a greater interest in gene therapy to fight the disease that claims two million lives each year," the AP/Google.com reports. Although the patient 20 months after the procedure has not shown signs of the virus, Andrew Badley -- director of HIV and immunology research at the Mayo Clinic in Rochester, Minn. -- said the tests that determine the patient's HIV viral loads likely have not been extensive enough. "A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Badley said. Fauci said the procedure was too expensive and dangerous to use as a first-line therapy. However, he said it could inspire researchers to pursue gene therapy as a way to block or suppress HIV. "It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate," Fauci said. David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, added that gene therapy as inexpensive and effective as current drug treatments is in the very early stages of development. "That's a long way down the line because there may be other negative things that go with that mutation that we don't know about," he said (McGroarty, AP/Google.com, 11/13).

    * Reuters: Hutter and his team said that although they have not been able to find any traces of HIV in the patient, it does not mean he has been cured. "The virus is tricky. It can always return," Hutter said. According to Reuters, the researchers said that bone marrow transplants could never become a standard HIV/AIDS treatment because the transplants are "rigorous and dangerous and require the patient to first have his or her own bone marrow completely destroyed." In addition, the procedure can be fatal because patients have no immune system until the stem cells can grow and replace theirs, leaving them susceptible to even minor infections (Reuters, 11/12).

    * Deutsche Welle: According to physicians at the Berlin hospital, they are continuing to monitor the patient's health and are prepared to put him back on antiretrovirals if the virus reappears. Thomas Schneider, Charite's director of infectology, said, "We cannot say with certainty that the virus won't begin replicating itself in the future," adding, "But the mere fact that it hasn't yet done so is a minor sensation" (Deutsche Welle, 11/13).

Offline leit

  • Member
  • Posts: 236
Re: German transplant operation eradicates HIV
« Reply #26 on: November 19, 2008, 10:37:30 PM »
I also think that all those scientist who are working since years for a solution to HIV are looser.
The approach of the Dr Hutter is so obvious (and many others approach are) but big pharma just prefer produce pills able to almost keep chronic this disease.

I agree. As I recently wrote to a very smart friend: "IMHO, the "year of the big mistake" was 1997, when David Ho's theory about eradication by HAART in 2-3 years failed and Siliciano/Fauci/Richman calculated that about 70 years of complete virus suppression (not realistic!) were needed to eradicate HIV. Well, AT THAT TIME they should have dropped out HAART (big pharma would however have kept working on it, as it happened) and search for a REAL CURE. They didn't do it, and we are now taking the consequences."

Quote
It seems that for all these people and most patient, be cautious is the only way of thinking.

I don't believe I HATE HIV less than you do, "John2038". Nevertheless, I wouldn't like to switch from HIV to cancer or some other disaster. As you perfectly know, the immune system is incredibly intricate and delicate, and little is known about it. Moreover, gene therapies are far from being an usual practice (think about bubble boys' "success" and then... leukaemia).



Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #28 on: November 20, 2008, 01:30:37 AM »
I don't believe I HATE HIV less than you do, "John2038". Nevertheless, I wouldn't like to switch from HIV to cancer or some other disaster. As you perfectly know, the immune system is incredibly intricate and delicate, and little is known about it. Moreover, gene therapies are far from being an usual practice (think about bubble boys' "success" and then... leukaemia).

What about all those people who have die from HIV ? If some of them have got such treatment as an option, instead of nothing, maybe some of them will have live longer, and maybe the way of doing chemo will have improve so much that the death rate will have significantly drop to become a possible treatment (which doesn't necessarily would have involve chemo, but any others safe ways the research might have found since).

The Dr Hutter approach is the second one I know to have been documented in the past 25 years.
After so many deaths, it's an extremely very rare event. Thanks for him to be a hematologist, and not one of these incompetent or cautious ID doc.

Some ID doc are definitely great, the vast majority don't even know better than you what could be your next combo.

In the long list of the things that upset me in the management of this disease, the last one is about the drug to choose.
Isentress is an integrase inhibitor. Compared to the others drugs, it is working at the very beginning of the virus replication cycle. And not surprisingly, it is one of the best ever HIV drug never created.
It seems so obvious to me that consequently, this drug should be prescribed in first line regimen, if it is financially possible. But if you talk to your ID doc about starting with it, he will very probably be willing to start with a much more conventional regimen, just to stay in the comfort zone, without any money consideration. For me, we have accumulate already enough data about Isentress to decide to use it in first line regimen, and without having to remain as usual extremely cautious.

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #29 on: November 20, 2008, 11:58:38 AM »
Not a good news, but nothing we don't know, unfortunately

http://forums.poz.com/index.php?topic=20441.msg306544#msg306544
« Last Edit: November 21, 2008, 01:46:34 AM by John2038 »

Offline NewYorkKat

  • Member
  • Posts: 134
  • Hangin' On Staying Strong
Re: German transplant operation eradicates HIV
« Reply #30 on: November 20, 2008, 01:28:38 PM »
I agree with John2030. USE ME AS A GUINEA PIG!!!

20-30% failure is a lot better than 50 to 70%!



When I had lasik done, I said I wanted both eyes instead of one. I risked it and now my vision is 20/20.

Anything to rid of this thing!


Offline NewYorkKat

  • Member
  • Posts: 134
  • Hangin' On Staying Strong
Re: German transplant operation eradicates HIV
« Reply #31 on: November 20, 2008, 01:33:13 PM »
Excuse me John2038. My vision is fine but my memory fades.... ;D

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #32 on: November 21, 2008, 01:47:51 AM »
Ohh NewYorkKat, lets do it together
« Last Edit: November 21, 2008, 02:00:46 AM by John2038 »

Offline blondbeauty

  • Member
  • Posts: 1,784
Re: German transplant operation eradicates HIV
« Reply #33 on: November 23, 2008, 06:36:59 PM »
The news is interesting in the field of HIV research. But as I have posted in the Spanish forum, transplant is not the best solution for the following reasons.
1) You have to find a compatible donor.
2) The donor has to be compatible and immune to HIV. The chances of this to happen are less than winning the lottery.
3) It is safer, easier and much more effective to take antirretrovirals than taking immunosuppresors to accept the transplant.
The only member in these forums approved by WINBA: World International Nail and Beauty Association.
Epstein Barr +; CMV +; Toxoplasmosis +; HIV-1 +.
Counts when starting treatment:
V.L.:80.200 copies. CD4: 25%=503
Started Sustiva-Truvada 14/August/2006
Last V.L.count (Oct 2013): Undetectable
Last CD4 count (OCT 2013): 52%= 933

Offline hahaha

  • Member
  • Posts: 123
Re: German transplant operation eradicates HIV
« Reply #34 on: November 24, 2008, 08:09:59 AM »
I have a feeling that probably transplant is the only solution for "cure" in the near future.
There are 4 reasons"
1. a cure  need to source out and delete most of the CD4 and other reservoir that are infected.
2. a cure need to "refresh" and "recover" CD8's memory for its impair function.
3. a cure need to fix the problem that the clean CD4 remain unattacked.
4. a cure need to  come out with a complicate immune function (including the complicate interaction between all kind of white cell, B cell, dentritic cell, brain) that is capable of fighting HIV.

Due to the transplant, most of the "bad reservior" has been x-rayed and killed, so 1 has been solved.
the transplant will create new born CD8, that the fuction has not been impared. 2 then solved
the transplant of CCR5-defect cells protect CD4 unattacked.
the transplant will again, creat new cells (B cells...) that fight back HIV.

If the quantity of transplant of cell is large enough, it will ceate a envioroment similar to a healthy person just being infected or attacked by less than 3000 HIV. which may lead to a good possiblity that the body may kill HIV easily and remain uninfected.


Just a wild guess for fun, don't take it serious.       
Aug 9, 2006 Get infected in Japan #$%^*
Oct 2006 CD4 239
Nov 2006 CD4 299 VL 60,000
Dec 1, Sustiva, Ziagan and 3TC
Jan 07, CD4 400

Offline freewillie99

  • Member
  • Posts: 311
Re: German transplant operation eradicates HIV
« Reply #35 on: November 24, 2008, 09:35:14 AM »
This post was deleted due to unnecessary rudeness.  :D
« Last Edit: November 24, 2008, 11:30:02 AM by freewillie99 »
Beware Romanians bearing strange gifts

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #36 on: November 24, 2008, 10:57:44 AM »
I always wonder why people force themselves to not live in a better world, avoiding for e.g judging others.

hahaha, the good idea in your approach is that by enumerating the different steps that might lead to a cure, we can then review them to see if for each step, it exist alternate safer ways, for e.g

About what you said, at least you have tried to propose, and that's always a good things

Offline David Evans

  • member
  • Member
  • Posts: 97
Re: German transplant operation eradicates HIV
« Reply #37 on: November 24, 2008, 11:25:23 AM »
Hi folks,

Let's watch the insults. If someone posts something that doesn't make sense for some reason - and you know why they aren't making sense, either ask further questions or provide the info they're missing. We're all just trying to educate one another.

In terms of hopes about the transplant, as I've said before hope is a great thing - it's vital. But it also makes sense to try and place our hopes where they have the greatest chance of becoming reality. I don't think anyone can say with 100 percent certainty that we'll never try this on people who don't otherwise need a stem cell transplant (i.e. for cancer). There are, however, some legitimate arguments against it - and bringing them up doesn't mean that a person is trying to destroy another person's hope. It's just acknowledging the obstacles that exist.

First of all stem cell transplants are dangerous - as others have said. Up to 30 percent of people who have them done die within days or weeks of the procedure. That's a very high rate of death. Because of this (before we ever get into the issue about costs) it is likely that the only candidates who would be deemed ethically acceptable would be those people who have not only failed all antiretroviral (ARV) drugs, but who are also very ill and at high risk of dying in the near future. It's just basic medical ethics. As sucky as it can be to live with HIV, and to deal with the the ARVs, no ethical doctor would would take that risk with someone who had other, less risky treatment options.

Then there's the cost. Right now, in the United States, some insurance companies still refuse to cover the cost of stem cell transplants in people with just cancer. They claim it is still "experimental." The costs can run well over $200,000. Granted, if a person was truly cured, then the amount saved from not being on life-long ARV therapy would be greater than $200K - but it will likely take a high rate of successes in people w/both HIV and cancer before payers would mostly likely even consider covering the costs.

-David

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #38 on: November 24, 2008, 11:40:19 AM »
David,

there are still at least 3 questions.

1) We know that this procedure is especially dangerous just after the transplant, until the immune system is becoming enough strong to protect the patient again.

So isn't the problem just related to the efficiency of the bubble room ? (at least, we can transpose the problem there)
If so, isn't it something we can improve (assuming no others problems for the transplant, such as its rejection, etc)

2) Can transplant ourselves, after a washing procedure ?

3) What would be the mortality rate if a chemio + transplant is made in someone almost healthy, instead of in the terminal stage of the disease ?

Offline leatherman

  • Member
  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: German transplant operation eradicates HIV
« Reply #39 on: November 24, 2008, 03:23:26 PM »
3) What would be the mortality rate if a chemio + transplant is made in someone almost healthy, instead of in the terminal stage of the disease ?
every time I see the threads about this issue, I have two thoughts:

first, what effect did the leukemia have on this patient's treatment outcome? Does this only "work" if you have leukemia in conjunction with HIV? would you still have these results with a different illness, or with no illness?

second, chemo is not something to be taken lightly. It is a very harsh treatment and quite a number of people do not survive this treatment; and of those that do "pull through", it's often after months and months of intense sickness, hair loss, etc. I don't have any knowledge about the side-effects of a bone marrow transplant, but I would imagine that it comes with it's own set of lethal problems too.

----------------------------------------------------------------
Just my personal thoughts about this kind of treatment and it's effects:

I would suggest visiting the oncology floor of your local hospital before considering this a viable kind of treatment. Having spent almost 60 days on that floor with my partner earlier this year and seeing the other patients (without the complication of HIV) come and go (and many who left did not go home but went to the morgue), I would be hard pressed to have chemo on myself if I found out I had cancer along with my AIDS.

Didn't I read that one of these "cured" patients died a few months later anyway? My partner had AIDS and non-Hodgkins lymphoma. After going through 2 rounds of chemo which did not work against the cancerous tumors, he passed away a month later. I still have unresolved feeling about the suffering we and the doctors put him through before his eventual death. Dying is bad enough without suffering from the "treatment" at the end.

Actually seeing what I did in those months, I would not go through chemo for any reason at this point in my life. right now, living with HIV is hard enough - and I'm at a stable level - without adding leukemia, chemo, marrow transplants, and all the side effects from those, just on the off chance of being "cured" if I lived through it all.

mikie
who is just not enough of a gambler to be a guinea pig
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #40 on: November 24, 2008, 05:17:07 PM »
leatherman

you are one of the great guy in this forum. You have been through so many things. But still nice and polite. What you are saying must make sens, despite that in the bottom of my heart, I could potentially do whatever it take to get ride of this virus. Should I die, I will have kill it.

But you make me think a bit more.
I will travel to EU next month, and I was willing to contact the Dr Hutter, to discuss with him the possibilities, odd to survive and so. And if he agree, if I agree, and if the cost can be covered by a special fund, I might try.

I don't find it funny to survive to this bug, waiting the next combo, hoping the cure, despite I never got real symptoms, still out of meds, healthy, but already multi-resistant.
Yep, got a happy life, still.

But if the odd to survive could become much higher (such as 95% +) cause of my good health right now, I think it's something to try.

On the other hand, your advices based on your experience are important too.
Thanks !

Note
Yep, not the place to talk about feeling. But taking such decision is still in the scope of this thread I guess.
« Last Edit: November 24, 2008, 05:18:47 PM by John2038 »

Offline leatherman

  • Member
  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: German transplant operation eradicates HIV
« Reply #41 on: November 24, 2008, 06:08:30 PM »
not the place to talk about feeling. But taking such decision is still in the scope of this thread I guess.
I understand; however I thought because some people discussed utilizing the actual procedure, that a discussion of the possible ramifications would be appropriate.

Similar to the way some of the general population view HIV as an easy illness now ("chronic and manageable". and no, I'm not discussing the truth of that statement, just pointing it out as a general opinion in the public arena), seeing people bat the word "chemo" around like it's an easy treatment made me want to point out that just surviving the chemo is a huge feat in itself and shouldn't be minimized when looking at this scenario for a "cure".

Just like the issue with leukemia. If that's the route to this "cure", would you really want to get leukemia and deal with those issues to finally reach the ultimate "cure"? Each person would have to make his or her on judgement call on that based on health status and other criteria. Having been as sick as I was, I've already had to evaluate what sort of treatments I'm willing to take in relationship to quality vs quantity of life. (there's a lot of stuff, I won't do: I won't take meds if I have to throw up again EVERY day; I won't do chemo for cancer because I don't think my health is good enough and I'm prejudiced against it after seeing what I saw in the hospital) With Jim, we made those same decisions. I saw several older men in the oncology dpt also make that decision, and go home to some quality of life rather than quantity (and only "possible" quantity if the treatment actually worked. no guarantee given for that though).


What you are saying must make sens, despite that in the bottom of my heart, I could potentially do whatever it take to get ride of this virus. Should I die, I will have kill it.

I was willing to contact the Dr Hutter, to discuss with him the possibilities, odd to survive and so. And if he agree, if I agree, and if the cost can be covered by a special fund, I might try.

I don't find it funny to survive to this bug, waiting the next combo, hoping the cure, despite I never got real symptoms, still out of meds, healthy, but already multi-resistant.
Yep, got a happy life, still.

But if the odd to survive could become much higher (such as 95% +) cause of my good health right now, I think it's something to try.
I don't suggest not checking into this though.  ;) I know that you're quite intelligent and informed. I even agree with your notion that more "thinking outside the box" might find the road to the cure. On one hand, this procedure just looks like a last very desperate attempt, which unfortunately has meant that it's been performed on patients who had low odds of survival even before this radical of a treatment. On the other hand, risking this sort of treatment on a healthy person has a slew of ethical implications, so it will probably be very difficult to get results based on someone with better health.

Perhaps more will be learned from this though, and more knowledge definitely will lead to a cure. ;D
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #42 on: November 25, 2008, 10:52:32 AM »
leatherman

you have well describe how it might be to be part of the 30% of people for who this treatment might/have failed.

Now, this procedure is supposed also to work for the 70% remaining.
For those people, if this treatment lead to a cure, no more drugs, no more worries, normal life, almost.

Those who have died in the 30% have die of their cancer, not of HIV.

So the questions:

1) Can we better secure the period betw the transplant and the recovery of immune system ?
2) Can transplant ourselves, after a washing procedure ?
3) Will the mortality rate decrease if a chemio + transplant is made in someone almost healthy, instead of in the terminal stage of the disease ?

A positive to any of these 3 questions will provide better odds.

Offline Peter Staley

  • Member
  • Posts: 1,337
  • Founder & Advisory Editor, AIDSmeds.com
    • AIDSmeds.com
Re: German transplant operation eradicates HIV
« Reply #43 on: November 29, 2008, 10:30:58 AM »

Those who have died in the 30% have die of their cancer, not of HIV.


Not true.  Many died from opportunistic infections after their immune systems were wiped out by the procedure.

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #44 on: November 29, 2008, 12:56:24 PM »
Hi Peter

my argument was that those 30% have died from the OI/non-OI they got diagnosed before the chemo (despite I just wrote cancer)

This to says : how much this percentage will be for those with HIV but without OI/non-OI before doing the chemo ?

Sorry for the shortcut.
« Last Edit: November 29, 2008, 02:07:52 PM by John2038 »

Offline SASA39

  • Member
  • Posts: 690
Re: German transplant operation eradicates HIV
« Reply #45 on: November 29, 2008, 09:06:15 PM »
2 questions :
1.Doctors have statted that they`ve  done  a biopsy tests which has concluded that a famous "German patient" do not have HIV virus in his anal cells , liver etc, etc ...
But what about latent viral reservoir tissues such as brain , nerves , etc , etc ?
2."German patient" has inhereted CCR5 delta 32 mutation , that`s OK , but what if gp120 find a CCR4 mutation - or in other words in a case of dual tropism is he safe enough ?
edited for typo

Oct.     `06.  CD4=58  ?    %       VL not perform. ?!?
25.Dec.`06.         203       14        VL= 0
29.May.`07.    broken device        VL=1363
20.June`07     broken device        VL=0
25.Dec `07  CD4=582                  VL=70
14.May `08  CD4=448
29.July `08                                  VL=0
26.Nov `08  CD4=674                    VL=179
16.Mar `09  CD4=554                    VL=0
19.Jan`10 CD4=715               
03.Mar`10                                    VL=0
24.Aug`10 CD4=524                     VL=0
04.Dec`10 CD4=626                     VL=0
15.Sep`11                                   VL=93
17.Nov`11                                   VL=0
05/26 .Jul`12 CD4=713                 VL=0
28.Nov`12 CD4=916                     VL=0
09.May`13                                 VL=0

Offline Peter Staley

  • Member
  • Posts: 1,337
  • Founder & Advisory Editor, AIDSmeds.com
    • AIDSmeds.com
Re: German transplant operation eradicates HIV
« Reply #46 on: November 30, 2008, 02:28:59 PM »
Hi Peter

my argument was that those 30% have died from the OI/non-OI they got diagnosed before the chemo (despite I just wrote cancer)

This to says : how much this percentage will be for those with HIV but without OI/non-OI before doing the chemo ?

Sorry for the shortcut.

You don't have to have a prior OI.  You can die from any new infection that occurs before the new immune system takes hold.  You can die from a new infection you get in the hospital, for instance.  The 30% death rate is for HIV NEGATIVE patients.  I'd imagine as pozzies, our rate would be higher.

Offline John2038

  • Member
  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: German transplant operation eradicates HIV
« Reply #47 on: November 30, 2008, 04:20:30 PM »
Eish

I was assuming people were doing chemo only when they was having an OI/non-OI
So that the 30% apply to those who are having a cancer for example.

My guess: HIV shouldn't impact the chemo outcome if there are no pre-existing OI/non-OI.
Cause HIV is destroying the immune system, exactly what the chemio does, but radically.

Consequently, IMHO these 30% are the same for those coinfected or not with HIV.

Now, chemo haven't been tested on healthy people, or people almost healthy (HIV positive but controlling their infection, with no OI/non-OI).

As such, for those people, the odds to survive seems to be better than these 30%.

I do not say I am right, just an opinion, and I appreciate to be able to talk about it with people having better background than me.

Offline SASA39

  • Member
  • Posts: 690
Re: German transplant operation eradicates HIV
« Reply #48 on: November 30, 2008, 08:05:49 PM »
And answers to my 2 Q........................? ???
Oct.     `06.  CD4=58  ?    %       VL not perform. ?!?
25.Dec.`06.         203       14        VL= 0
29.May.`07.    broken device        VL=1363
20.June`07     broken device        VL=0
25.Dec `07  CD4=582                  VL=70
14.May `08  CD4=448
29.July `08                                  VL=0
26.Nov `08  CD4=674                    VL=179
16.Mar `09  CD4=554                    VL=0
19.Jan`10 CD4=715               
03.Mar`10                                    VL=0
24.Aug`10 CD4=524                     VL=0
04.Dec`10 CD4=626                     VL=0
15.Sep`11                                   VL=93
17.Nov`11                                   VL=0
05/26 .Jul`12 CD4=713                 VL=0
28.Nov`12 CD4=916                     VL=0
09.May`13                                 VL=0

Offline David Evans

  • member
  • Member
  • Posts: 97
Re: German transplant operation eradicates HIV
« Reply #49 on: December 01, 2008, 01:01:08 AM »
Dear all,

I've actually been in the process of writing up a new Web Exclusive on this topic that will be up on the site Tuesday evening, but I'll weight in here in advance. I'm not a transplant expert, but I do know that the chemotherapy and radiation that is necessary for a bone marrow (i.e. stem cell) transplant is pretty radical and very toxic to the body, HIV present or not. For someone whose immune system has already been severely depleted by HIV infection, it can, in fact, be worse, quite a bit so.

Think about traditional chemotherapy for many other types of cancers. It is almost always done on an outpatient basis. The lymph ablation that occurs with stem cell transplants is so intensive that most centers only do it on an inpatient basis so as to be able to respond quickly to life threatening infections. Researchers, including those working on gene therapies for HIV, are trying to find safer ways to free up space for the new stem cells, but we just aren't there yet.

I've never been tempted by the gambling bug but I'd bet a lot of money that we aren't likely to start doing traditional stem cell transplants on people with HIV who don't otherwise need it. If the Berlin case does get well confirmed by outside researchers, it is most likely that this will be tried on other patients with leukemia and lymphoma first.

Hopefully by the time we've gotten more data from those additional cases, the gene therapy, RNA interference and zinc finger field will have progressed enough that they'll end up being more viable options. One of the benefits of using a person's own stem cells is that you don't have to find a good genetically matched donor - a process that's already challenging when you're not also trying to find a donor who can't make CCR5. This is even more vital when you're talking about the majority of the people on the planet who have HIV, who are of African descent, and in whom there are no such donors.

Unfortunately, when you're talking about infusing a person with stem cells, whether they're from their own bodies or someone elses, you still currently have to kill off most of the existing stem cells so that the new ones will take root and flourish. That means even with gene therapy, we're still talking about a course of potentially lethal chemotherapy and/or radiation - at least at the present time.

As the researcher I spoke to for the report said, they're intensively looking for ways to kill off those stem cells without destroying a person's immune system in the process. They've made progress with targeted antibodies in mice, but they've still got a lot of work ahead of them.

As I said before, I remain ever hopeful, but if there's one thing we've learned in this epidemic, and a principle to which the forums and AIDSmeds is dedicated, it's to become informed about all the risks and rewards about treatment before making big decisions. That doesn't make us pessimists, just that we are taking responsibility for our bodies and our lives.

I think the same is true when considering the implications of the Berlin transplant. At the very worst, we may find that there is still HIV present in the gentleman who got the transplant and that the improvements were temporary. Even then we'll have learned things that will move AIDS research forward. There's a good chance that the outcome will be more favorable than that, and the advances this could help propel in HIV research will be even larger. I think that's a very hopeful view to take. It's probably a bit early to argue about whether it's appropriate for people to undergo toxic chemotherapy and risk death for a possible cure. Instead, lets hope that by the time the research catches up with this Berlin case and becomes a reasonable option for more than a handful of people, the risks won't have to be so high.

Respectfully,
David

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.