POZ Community Forums
Meds, Mind, Body & Benefits => Research News & Studies => Topic started by: sensual1973 on July 03, 2013, 06:48:20 am
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http://www.bbc.co.uk/news/health-23132561
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Good to hear more people getting 'cured'. I wonder if the CCR5-Delta32 in Tim's case was really necessary (and sufficient?) to cure him. It could have been the chemotherapy.
http://www.nature.com/news/stem-cell-transplants-may-purge-hiv-1.13297
Brown was given stem cells that were predisposed to resist HIV infection, because the donor happened to have a mutated version of a key protein — CCR5 — that is needed for HIV to infect cells. So Brown’s transplant was akin to gene therapy with HIV-resistant cells.
But the Boston patients received stem cells without the protective mutation. The transplanted cells must therefore have been protected from infection by the antiretroviral drugs taken during cancer treatment. Their doctors think that an immune response called graft-versus-host disease — a post-transplant reaction in which donated cells kill off a patient’s own cells — may have then wiped out the patients’ HIV reservoirs, potentially curing the men.
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http://www.bbc.co.uk/news/health-23132561
Some have beat me to it on here already, and we don't want to get too excited yet, but it seems there may be some hope about curing HIV/removing it from the blood via bone marrow transplant. The virus lives in the blood so it does make sense that if all blood is removed and transplanted, the virus does not return. Hopefully, scientists will find a way to do this without the extreme of a bone marrow transplant, as that is an extreme case, and this information was essentially found by accident, as the men involved in this story had cancer and happened to have HIV as well, and they found that the HIV has not returned to their bodies as of yet. Hopefully this will give research a whole new avenue to pursue, there have been so many false hopes over the years, I hope there's something to this. The meds we have today are great, but nobody wants to be on anti-retroviral meds their whole life, a cure is the ideal situation. I am an optimist and hope this is one small ray of hope we can hold onto for the future.
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Another man from Rmany, a 67 year old man who started HIV treatment shortly after diagnosis (within three months) his viral load was over one million at the time and cd4 count just under five hundred.
He started treatment right away with AZT, 3tc, and efavirenz. It's believed that since he was able to start treatment so soon after seroconversion he was ale to control the virus.
http://mobile.aidsmap.com/German-researchers-report-case-of-functional-cure-after-very-early-HIV-treatment/page/2691566/?utm_source=NAM-Email-Promotion&utm_medium=conference-bulletin&utm_campaign=English
There was also info presented at IAS about two from Boston who may be "cured" after receiving a stem cell transplant. This news has been reported previously however, the last time it was reported they were still on HAART. They have stopped HAART and are still maintaining viral control.
Lots of cure reports at IAS this year, that's a bit coo!
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Lots of cure reports at IAS this year, that's a bit coo!
The news over the last year has been amazing - we have gone from one person to nineteen cured or at least in remission (not counting Dr. Basara's patients, yet...) within a very short period of time. Perhaps we'll need a "counter" on the front page of Poz.com to track the number of people cured or in remission.
In reading the IAS news I am also struck by how sensitive all of the reports are to not blow any of the results out of proportion -- all of them that I have read point out that we still have a very long way to go. There is clearly an attempt to keep the media from going overboard, which is good.
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I merged all three threads started on this subject, and kept the best (most descriptive) title.
Please keep all further posts about this latest bone-marrow (don't say the C word just yet) news in this thread.
Any further new threads started on this subject will be deleted.
Thank you all for your cooperation and help in keeping this section of the forums tidy and easily searchable.
Ann
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Well this is certainly exciting! Sign me up! Er...just a sec...20% mortality, immunosuppressant drugs afterwards... hmmm... guess not!
But...wow! This is really great news and I'm sure it's got a lot of smart people thinking about safer, cheaper stem cell transplants or other ways to mimic the transplant.
Sure seems like the graft vs. host disease is what did the job. I wonder if that would occur with autologous transplants. Of course, it could also have been the chemo that did it, but I don't think so since they still had a VL after the chemo and it went down over time. That seems to me like something like the GHD was doing the job.
This is really good news. It'll be wonderful if they stay UD. Time will tell.
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I thought they already found the cure for AIDS
http://www.zimbio.com/watch/WIoYa6MtBSu/They+Found+a+Cure+for+AIDS/South+Park
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I still find it a bit hard to believe that a bone marrow transplant alone is enough to get rid of the virus.
Surely, Timothy Brown wasn't the first HIV positive person to receive a bone marrow transplant.
Shouldn't there be many more cured people like him then?
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Good question. According to data by the US Dept. of Health and Human Services, "over 17,900 bone marrow or umbilical cord blood transplants were performed in the United States in 2011". You would think that at least 1 in 1,000 would be poz recipients.
http://bloodcell.transplant.hrsa.gov/about/general_faqs/index.html#1990 number tx in US
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I remember reading that some guy( Franch?) was given a bone marrow transplant in the mid 90s. His viral load was going down the Hill after the transplant. But he died a few months after for something related to the cancer or the transplant.
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http://www.nhs.uk/Conditions/Bone-marrow-transplant/Pages/Risks.aspx
I am hopeful too = but the risks involved in this procedure are high and it is certainly a nasty procedure to go through with the radiation/chemo..... I'm just thinking about quality of life afterwards.... I watched my sister go through chemo for bowel cancer and it wasn't pretty.
I would like to know what quality of life is like for these people now.... today......
I also thought there were reservoirs of the virus in the Lymphatic system and in the gut etc? Blah... I dunno.... time I suppose will be the final decider.
Looking forward to more information on this..... if I get one more Facebook inbox comment from a friend telling me I am cured I think I will throw my laptop over the balcony! ;)
P
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Here's another brief article about the two Boston stem cell transplant patients who show no trace of HIV months after being taken off meds. The article mentions that they did not undergo the same kind of intensive chemo that Timothy Brown did, but I'd be interested in knowing more details about the procedure they went through. Hopefully they are both in fact functionally cured.
http://www.sfgate.com/business/bloomberg/article/Stem-Cell-Transplants-Clear-HIV-in-Two-Boston-4644701.php
Stem Cell Transplants Clear HIV in Two Boston Cancer Patients
Simeon Bennett, ©2013 Bloomberg News
Published 6:25 am, Wednesday, July 3, 2013
July 3 (Bloomberg) -- Two HIV patients in Boston who received stem-cell transplants for cancer had no trace of the AIDS-causing virus after the procedure, suggesting they may have been cured.
The two patients, treated at Brigham and Women’s Hospital, stopped HIV treatment after the transplants, which in other patients has opened the door for the virus to come roaring back. In one patient there was no sign of the virus 15 weeks after stopping treatment, while the other has gone seven weeks without HIV rebounding, according to results presented today at the International AIDS Society’s meeting in Kuala Lumpur.
The researchers led by Timothy Henrich of Harvard Medical School and Brigham and Women’s Hospital said it’s too early to conclude the two men have been cured and the virus may be lingering in their brains or gut. Still, their cases are similar to that of Timothy Brown, the so-called Berlin patient, who was the first person to be cured of HIV after getting a bone marrow transplant for leukemia in 2007.
“While stem-cell transplantation is not a viable option for people with HIV on a broad scale because of its costs and complexity, these new cases could lead us to new approaches to treating, and ultimately even eradicating, HIV,” Kevin Robert Frost, the chief executive officer of amfAR, The Foundation for AIDS Research, which funded the study, said in a statement.
Drug Cocktails
There was one main difference between Brown and the two Boston men: the cells he received contained a rare genetic mutation called CCR5 that made him resistant to HIV infection. The donors in the new cases lacked that mutation, and the Boston patients didn’t undergo the intensive chemotherapy Brown did.
Scientists had believed the CCR5 mutation was key to Brown being cured. They’ll be scouring the new evidence for clues to whether other genes may hold promise against HIV, Rowena Johnson, amfAR’s director of research, said in an e-mail.
While AIDS drugs such as Gilead Sciences Inc.’s Atripla reduce HIV to undetectable levels in the body, making it a chronic disease, they don’t completely clear it. The virus hides in certain immune cells, where it switches off the normal process of replication. That enables HIV to avoid detection by the medicines, which are designed to block steps in its reproduction.
Studies have shown that when patients who have the virus under control stop treatment, latent HIV reactivates and comes roaring back, forcing victims to resume daily pill therapy.
Doctors in March said they had cured an infant born with HIV for the first time by treating her with AIDS drugs about 30 hours after she was born at a rural Mississippi hospital. At 18 months the mother took the child off medication, and when the virus had not returned 10 months later, she was deemed “functionally cured.”
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"There was one main difference between Brown and the two Boston men: the cells he received contained a rare genetic mutation called CCR5 that made him resistant to HIV infection. The donors in the new cases lacked that mutation"
how are they resisting the virus so far then?
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The new stem cells wiped out the old stem cells. It is called graft versus host disease. The new stem cells think that the old stem cells are foreign and attack them and destroy them. Meanwhile the new stem cells are not infected because they are still on medication.
That's the theory anyway from what I read.
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PS: I saw my doc for my regular check up and joked about scheduling my stem cell transplant. She shot me a sharp look which softened when I said I was kidding. She also said that the drugs I'm taking now are a lot easier on the system than the immunosuppressant drugs that go along with a SC transplant.
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Twelve-year-old Eric Blue has died from "a very bad form of graft-versus-host
disease".
The procedure, which was performed April 23, involved injecting Blue with blood cells from a donor with a rare genetic resistance to HIV, the virus that causes AIDS. Less than 1 percent of the population is born with this genetic resistance, according to Verneris. Doctors hoped the transplant would rid the boy’s body of both the leukemia and HIV and help fight off any recurrence.
While not yet conclusive, tissue and blood tests obtained through Blue’s treatment have shown an absence of HIV, even after his medications were discontinued, Verneris said.
“There was no sign of leukemia either for that matter,” he said. “Things were looking quite bright. Of course, that makes it even more bittersweet in some ways … that he was almost there.”
http://www.startribune.com/local/215290391.html (http://www.startribune.com/local/215290391.html)
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Bittersweet if in fact data shows absence of HIV. The evidence is pointing more and more towards graft-vs-host disease as the key in eliminating HIV from the body. RIP Blue.
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I'm not sure if this was posted, but this is a video of the Late Breaker presentation in which one of the researchers talks about the 2 Boston patients. His presentation starts at about 14:00 minutes.
http://www.youtube.com/watch?v=1tFA9-Ri-V4&feature=youtu.be