Two men cleared of HIV after bone marrow transplant (No CCR5 mutation)

[zettainaoru]

http://www.smh.com.au/national/hiv-cleared-in-two-australian-men-after-bonemarrow-transplants-20140718-zuizm.html

Two Australian men have ‘‘cleared’’ HIV after having bone marrow transplants to treat cancer, boosting hopes that a cure for the virus affecting 38 million people worldwide can be found.   
A team of Sydney doctors will announce on Saturday that extensive tests have found no sign of HIV in two men after they received bone marrow transplants to treat lymphoma and leukaemia three and four years ago. 
Significantly, the pair, aged 47 and 53, did not receive transplants from donors with two copies of a rare gene that protects less than 1 per cent of the population from HIV.
The only man in the world believed to be cured of HIV, American Timothy Ray Brown, received a bone marrow transplant from a donor with both copies of the protective gene known as the CCR5-delta32 mutation in 2008. He is no longer on antiretroviral therapy to treat HIV and remains clear of the virus.
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In 2012, two other HIV patients had bone marrow transplants from donors without the protective gene mutation in Boston. However, when they stopped taking antiretroviral treatment, the virus returned.
Leading HIV specialist at Sydney’s St Vincent’s Hospital David Cooper said one of the Sydney patients received a bone marrow transplant from a donor with one of two possible copies of the protective gene mutation while the other patient received one from a donor with no copies of it.
Given the Boston patients’ experience, he said both men remained on antiretroviral treatment to protect them from the virus returning. However, he said both men remain clear of HIV and the cancers for which they received the bone marrow transplants.
‘‘We’re so pleased that both patients are doing reasonably well,’’ said Professor Cooper, who also directs the University of NSW’s Kirby Institute. 
While the Sydney patients provide hope for HIV patients, all of whom carry a greater risk of various cancers, Professor Cooper said bone marrow transplants kill more than 10 per cent of recipients, making them an impractical method for treating HIV.
But he said each new case provided the opportunity for scientists to examine why the transplants appear to eliminate the virus and what can be done to mimic this process with a safer therapy. 
One of the researchers studying the Sydney patients, Dr Kersten Koelsch, said although the key mechanisms were unclear, it was possible aspects of bone marrow transplantation destroyed cells where HIV hides and that any remaining infected cells were killed by the patient’s new immune system afterwards.
Professor Cooper said the Sydney patients would be continually studied to try to find out where any residual virus might be hiding in their bodies. This is the big scientific question in HIV/AIDS research and is seen as an essential step towards finding a cure.
In the meantime, Professor Cooper said more HIV patients requiring bone marrow transplants were being studied, and that he hoped more would come forward to participate in trials in the future.
The research is being presented on Saturday at the Towards an HIV Cure Symposium - a satellite event of the 20th International AIDS conference beginning in Melbourne on Sunday.
There are currently more than 38 million people living with HIV and while antiretroviral therapies have turned the virus into a manageable chronic disease, millions of people in low and middle-income countries cannot afford to access the drugs.
In recent years, the search for a cure has been bolstered by several notable cases, including a Mississippi baby who remained clear of HIV for several years after receiving potent antiretroviral treatment immediately after birth.
While the case raised hopes that early treatment in the course of an HIV infection could cure people, the virus recently returned for the child, now aged four.

[dico]

The same story as the two Boston patients. Next.

[geobee]

They are both still on meds.  Next.

[sensual1973]

Boring.

[Cosmicdancer]

Perhaps the bone marrow transplant and chemo reduced their viral reservoir enough that they could eventually come off meds and be like the Visconti cohort, particularly the patient who got one of two possible copies of the protective gene mutation.  I'm not sure I'd be inclined to stop meds if I was them though.

[leatherman]

at least this article uses the word "cleared" rather than "cured". Although "eradicated" still might be a better word since chemo and bone marrow transplant procedures are pretty radical and run their own high rate of failure.

personally I often wonder how much having lymphoma and/or Leukemia affects the patient's immune system and influences the outcome. Would this same outcome happen to someone without those cancers? I certainly don't want to have lymphoma just to "cure" my HIV.