Man Officially Cured of HIV

[CaptainPanic]

A lot of media (BBC, Gizmodo (and a lot of others) report that a man was cured of HIV by a bone marrow transplant:

 

The treatment Brown underwent was aggressive: chemotherapy that destroyed the majority of his immune cells. Total body irradiation. Finally, a risky stem-cell transplant that nearly a third of patients don't survive—but that appears to have completely cured Brown of HIV.

 

Doctors were savvy when they chose a stem cell donor for Brown. The man whose bone marrow they used has a particular genetic mutation, present in an incredibly small percentage of people, that makes him almost invulnerable to HIV. With Brown's own defenses decimated by treatments, the healthy, HIV-resistant donor cells repopulated his immune system. The initial indications that the virus had abated were promising. But only just now, having taken no antiretroviral drugs since the transplant, and following extensive testing shows no signs whatsoever of HIV, have his doctors given the official word:

 

He's cured.

It's wonderful scientists / doctors continuously keep getting closer to curing HIV. Obviously, there is a lot of work to be done... but I have to say that this seems the most promising bit of news in many years.

[Stefan-CoA]

He's still a carrier for HIV though, if I understand the life-cycle of the bugger correctly. But yeah, this is fantastic.

[Doc. Josh]

However i wonder with the ongoing strains developing once they cure one 10 more become immune to the cure?

[imatfaal]

He's still a carrier for HIV though, if I understand the life-cycle of the bugger correctly. But yeah, this is fantastic.

 

For a disease rightly or wrongly associated with the male homosexual community a more reasoned choice of words might have been preferable.

[CharonY]

I have not read the article, but from the blurb the approach seems to be somewhat similar to this:

 

http://www.sciencefo...-in-hiv-patient

 

Edit: eh, it is the same article, it appears.

Edited May 20, 2011 by CharonY

[Marat]

This is typical of so much utterly useless, tour de force medical innovation nowadays, which results from the utter stagnation of genuine medical progress forcing researchers to attempt even more contrived experiments to get something, anything, that looks like an advancement, even though it will be utterly useless on an epidemiological level in improving the fate of patients.

 

Here we have a profoundly risky, carcinogenetic stem cell transplant, using someone with a ludicrously rare genetic mutation to provide bone marrow, which is extremely difficult to match under the best of conditions, involving the extreme risk of native bone marrow destruction, all just to overcome a disease which is now at least controllable by more ordinary interventions. It reminds me of the fantastically stupid hoopla a while ago over the Edmonton protocol for 'curing' diabetes by islet cell transplants which did not work very well in controlling blood glucose, involved extremely toxic immunosuppression, and could only treat fewer than 1% of all type 1 diabetics because of the limited number of donor organs. All this 'innovation' really accomplished was to demonstrate that by some highly elaborate scientific ingenuity it would be possible to overcome to a highly limited degree the biochemical measures of a medical problem, yet without really making any significant improvement whatsoever in the lives of patients, and certainly not any population-significant improvement in the condition of diabetics. Yet another triumph of modern medical research! -- Oh, and please give us tenure all around for the researchers plus another hundred million dollars for our lab as a reward.

 

The reason for the slow transition of medical science from bench to bedside which everyone is now talking about is that what is going on at the bench is just 10-year-old boys pulling wings off of flies to see what will happen, and little of it is truly patient-centered research. It is truly depressing to think of all the 'Run for a Cure' time, effort, and money being wasted by patients and their supporters in various diseases to sustain this type of time-wasting, let's see if we can graft one dog's head on another dog's neck and keep it alive for an hour, tour de force research.

[Cap'n Refsmmat]

It seems to me that finding a ludicrously rare genetic mutation which can provide a cure for HIV is a way of finding a pre-existing HIV cure which could potentially be much cheaper and more effective than cocktails of expensive side-effect-laden chemicals which must be taken for years, often by patients without the financial ability. Understanding the function of that gene would be a huge medical leap.

 

Of course, it would seem that modern medicine focuses on crazy one-shot stunts rather than sustained in-depth research. It seems that way because the only medical trials interesting enough to publish in popular news sources are the stunts. I can't imagine seeing the New York Times having the headline "Ten-Year Medical Trial Shows One Kind of Heart Pump Slightly Better Than Another."

[nec209]

This not news it was going for some time.

 

Some people are immune to HIV most are not this has puzzled doctors , And I read too that bone marrow transplant is ony cure now.

[CaptainPanic]

Hmm... very odd. The Dutch news I read initially reported it last week (multiple sources reported it on the 18th, 19th and 23rd of May 2011: link 1, link 2, link 3). Then I Googled it, found an identical article on the BBC and Gizmodo, and linked to that instead because most of you don't speak Dutch. I didn't check the date on those articles.

 

Now, to my surprise I find it's not news (it's old).

Anyway, it's interesting... just don't claim to anyone that this was recent, because it appears it wasn't.

 

Possibly just as interesting is how the media just seem to copy each other's stories without doing any checks. I didn't even put in all the Dutch links that reported this in the last week. It's rather pathetic to see all these media just writing about this story when it was such an old story actually. It shows again that you really have to use your own brain when reading the news.

[Marat]

The reason why there is so much reporting of old medical news as new is to disguise the general stagnation into which medicine has fallen. The public expects medical breakthroughs to occur all the time, the medical profession needs them to sustain its authority and inflated income, and the news media require them to sell advertising, so the temptation is irresistable to exaggerate medical progress. Every medical story you see in the media always mentions only the positive aspects of the intervention and never the downsides as part of a general propaganda effort to keep the public happy with the medical establishment, no matter how stagnant it has become.

 

Thus in the present case, there is no mention of the enormously high risk of graft versus host disease this patient will now have to endure as the price for escaping the AIDS threat, or whether he has had a T-cell-depleted bone marrow transplant to avoid GVHD, which then brings with it a massively increased risk of cancer or infection, just as would the immunosuppressive drugs he would have to take to suppress the GVHD risk. Overall, the patient has taken on more medical burdens than he has escaped, but a story like that lacks the necessary uplift required to sell advertising.

[CaptainPanic]

The reason why there is so much reporting of old medical news as new is to disguise the general stagnation into which medicine has fallen. The public expects medical breakthroughs to occur all the time, the medical profession needs them to sustain its authority and inflated income, and the news media require them to sell advertising, so the temptation is irresistable to exaggerate medical progress. Every medical story you see in the media always mentions only the positive aspects of the intervention and never the downsides as part of a general propaganda effort to keep the public happy with the medical establishment, no matter how stagnant it has become.

 

Thus in the present case, there is no mention of the enormously high risk of graft versus host disease this patient will now have to endure as the price for escaping the AIDS threat, or whether he has had a T-cell-depleted bone marrow transplant to avoid GVHD, which then brings with it a massively increased risk of cancer or infection, just as would the immunosuppressive drugs he would have to take to suppress the GVHD risk. Overall, the patient has taken on more medical burdens than he has escaped, but a story like that lacks the necessary uplift required to sell advertising.

Where lies the real pressure to publish "new breakthroughs" though? I think that the media are under much more pressure to come up with something, rather than the medical world...

 

But I do agree that the positive sides of breakthroughs are often highlighted while possible problems are mostly ignored. (But that's something that happens in the entire scientific world, not just the medical world!). I have never read an abstract of any paper that basically said that the new invention might solve one problem, but creates multiple new ones. The 'multiple new problems' are reported as 'recommended future study fields'... if they are reported at all.

[Marat]

Another odd thing about the research 'breakthroughs' and news reports in medicine, and perhaps in other fields as well, is that often things that have been known to clinicians for the last 20 years as working hypotheses or basic assumptions are suddenly 'discovered' in some published study that backs up these assumptions with statistics or lab work, so it now becomes 'true' and can be reported as 'major progress' in both medical circles and the public media. The fact that it only confirms what everyone already knew in practice is not mentioned.

[nec209]

I was reading here or on other group that they came up with drug that may work to fight HIV and other infectious diseases.

 

This still in research and development.

[DNA_demon]

I think I heard about this too. I know I read a few months ago in Science that there was some limited success with an HIV vaccine.

 

 

I was reading here or on other group that they came up with drug that may work to fight HIV and other infectious diseases.

 

This still in research and development.

 

 

 

 

 

Jarred Y

Web Developer

Claremont BioSolutions

www.claremontbiosolutions.com

[Cap'n Refsmmat]

Another odd thing about the research 'breakthroughs' and news reports in medicine, and perhaps in other fields as well, is that often things that have been known to clinicians for the last 20 years as working hypotheses or basic assumptions are suddenly 'discovered' in some published study that backs up these assumptions with statistics or lab work, so it now becomes 'true' and can be reported as 'major progress' in both medical circles and the public media. The fact that it only confirms what everyone already knew in practice is not mentioned.

 

I'd be very disturbed if my doctors were treating my cancer with a treatment everyone "knows" works despite having never been tested in a single clinical trial.

 

You'll also find that many news reports in medicine cover things everyone "knows" that have turned out to be completely wrong.

[Marat]

Perhaps I phrased that remark badly. Essentially I am referring to truths that were already long ago regarded as sufficiently well-established with epidemiological, experimental, and clinical results that they were part of routine clinical practice. Then suddenly the media will 'discover' these truths because a new and entirely superfluous 'flogging a dead horse' study is published that reconfirms the old truth by additional data. Suddenly what every new fellow in the discipline already knew as common knowledge since 1957 appears in the headlines as a 'breakthrough.'

 

Through this technique, medical 'progress' can be manufactured to fill any slow news day, and the same old results can be dressed up and trotted out every few years to make it seem as though things are actually getting better in medicine.

[Cap'n Refsmmat]

Why do you assume this is done to make it appear that medicine is progressing, rather than being done to fill slow news days in the media?

 

It's actually surprising how few major studies, cited and depended upon by thousands of doctors, are ever replicated and tested -- and often they turn out to be wrong.

[Athena]

This is typical of so much utterly useless, tour de force medical innovation nowadays, which results from the utter stagnation of genuine medical progress forcing researchers to attempt even more contrived experiments to get something, anything, that looks like an advancement, even though it will be utterly useless on an epidemiological level in improving the fate of patients.

 

Here we have a profoundly risky, carcinogenetic stem cell transplant, using someone with a ludicrously rare genetic mutation to provide bone marrow, which is extremely difficult to match under the best of conditions, involving the extreme risk of native bone marrow destruction, all just to overcome a disease which is now at least controllable by more ordinary interventions. It reminds me of the fantastically stupid hoopla a while ago over the Edmonton protocol for 'curing' diabetes by islet cell transplants which did not work very well in controlling blood glucose, involved extremely toxic immunosuppression, and could only treat fewer than 1% of all type 1 diabetics because of the limited number of donor organs. All this 'innovation' really accomplished was to demonstrate that by some highly elaborate scientific ingenuity it would be possible to overcome to a highly limited degree the biochemical measures of a medical problem, yet without really making any significant improvement whatsoever in the lives of patients, and certainly not any population-significant improvement in the condition of diabetics. Yet another triumph of modern medical research! -- Oh, and please give us tenure all around for the researchers plus another hundred million dollars for our lab as a reward.

 

The reason for the slow transition of medical science from bench to bedside which everyone is now talking about is that what is going on at the bench is just 10-year-old boys pulling wings off of flies to see what will happen, and little of it is truly patient-centered research. It is truly depressing to think of all the 'Run for a Cure' time, effort, and money being wasted by patients and their supporters in various diseases to sustain this type of time-wasting, let's see if we can graft one dog's head on another dog's neck and keep it alive for an hour, tour de force research.

 

 

Wow, you came down a little heavy on the researchers. It is not like boys pulling wings off flies, but is built on successful research to find out why some people don't get AIDS. It contributes to all research on gene therapy because it involves introducing genes, known to lock the cells against the damage caused by a virus. Unlike the treatment for diabetics, this gene therapy will protect everyone exposed to AIDS.

 

http://www.wired.com/medtech/health/news/2005/01/66198

 

Maybe bone transplants are risky and expensive, but the research is an important step in knowing what works. It also works to have a mother and father who carry the genes. If only one parent carries the genes the protection is not as good. I think given what we do know, the bone marrow transplant was justified.

 

 

The treatment for AIDS is way too expensive. Given our economic troubles, and the problem poorer nations have with treating people who need a very expensive medicine, we seriously need a better treatment for AIDS, and we could learn how to prevent the disease. That is better than medicine that treats the disease. Also, I recently read, people with AIDS who are treated, are experiencing premature aging. Medicines often take a terrible toll on the body.

Edited June 19, 2011 by Athena