By the way: HIV cured.

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By the way: HIV cured.

Postby Internetmeme » Wed Dec 15, 2010 5:15 am UTC

http://gizmodo.com/5713498/man-officially-cured-of-hiv
For the first time, a man has been declared officially cured of HIV. The remedy may nearly have killed him, but it opens a door—just a crack—to hope that we may someday kill off the scourge for good.

Strangely enough, the diagnosis that most concerned Timothy Ray Brown in 2007 was acute myeloid leukemia. HIV has been increasingly thought of as a manageable disease, though certainly a terribly burdensome one. What brought the 42-year old Brown under the care of Germany's Charite Universitatsmedizin Berlin hospital was the more immediate threat his cancer posed.

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.

What does this mean for the future of treatment? It's not as though every HIV patient can or would want to go through the tremendous suffering that was prelude to Brown's recovery, or be able to afford the procedure if they could or did. But for the first time, we know that HIV can be cured, not just managed. It opens new avenues of research—gene therapy, stem cell treatments—that may otherwise have been thought dead ends. [AIDS Map]

Sure, there's still no pill to take, but still. This is an important milestone: for the first time, we have cured a disease we thought incurable.
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Re: By the way: HIV cured.

Postby SummerGlauFan » Wed Dec 15, 2010 5:19 am UTC

Hmm, let's just get to work on making the stem cell transplant safer.

Really cool article! While truly not as easy or safe as taking a pill, surgery to cure HIV is amazing.
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Re: By the way: HIV cured.

Postby poxic » Wed Dec 15, 2010 5:20 am UTC

OH THANK THE FRICKING $DEITY [where $deity may be replaced with $science]. Now we just need to spend another decade or three on making this actually workable for others.
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Re: By the way: HIV cured.

Postby The Reaper » Wed Dec 15, 2010 5:21 am UTC

Oh yea, this guy. I remember this. Good on him. anti-rejection drugs are better than cancer AND aids.

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Re: By the way: HIV cured.

Postby sourmìlk » Wed Dec 15, 2010 5:27 am UTC

I wish I knew more about biochemistry and the likes so that I could comment on this. But that's cool.
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Re: By the way: HIV cured.

Postby kingofdreams » Wed Dec 15, 2010 5:54 am UTC

so is aids still the wrath of a vengeful god or what?
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Re: By the way: HIV cured.

Postby M.C. » Wed Dec 15, 2010 6:27 am UTC

kingofdreams wrote:so is aids still the wrath of a vengeful god or what?

Yep - it was only cured using (presumably) satanic stem cell research.
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Re: By the way: HIV cured.

Postby BlackSails » Wed Dec 15, 2010 6:34 am UTC

Marrow transplants have nothing to do with stem cell research, its just that you are transplanting various progenitor cells in the marrow.

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Re: By the way: HIV cured.

Postby Gelsamel » Wed Dec 15, 2010 8:11 am UTC

Paper here.

Also it's only HIV-1 that this method of removing CCR5 receptors works to cure by the way... That being said it is by far the most prevalent form of the virus.
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Re: By the way: HIV cured.

Postby Aetius » Wed Dec 15, 2010 9:11 am UTC

It's a bit humbling to realize that for all the amazing work that was done here, the human contribution amounts to "we got nature in the right place to do the hard work."

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Re: By the way: HIV cured.

Postby Ulc » Wed Dec 15, 2010 10:28 am UTC

Aetius wrote:It's a bit humbling to realize that for all the amazing work that was done here, the human contribution amounts to "we got nature in the right place to do the hard work."


That sentence describe pretty much every cure for disease that we use - halt the disease long enough for the body to do the work.

This is really impressive though, even it is unlikely to be replicated any time soon, as it was a pretty drastic cure.
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Re: By the way: HIV cured.

Postby dedwrekka » Wed Dec 15, 2010 11:02 am UTC

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.


I remember reading (and watching) about the HIV-1 immunity, several years ago. There was even some genetic testing done that traced back a number of those found with the immunity to a specific medieval village, and even to an anthrax or anthrax-like event in the town which may have started the mutation.
At the time I was entertaining pipe dreams of a human made virus that could be used to create the mutation in cells of people that lack it.

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:


The biological equivalent of wiping the hard drive and installing a new operating system.

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Re: By the way: HIV cured.

Postby Aikanaro » Wed Dec 15, 2010 12:13 pm UTC

Thank you for this, I needed something to brighten my day :D
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Re: By the way: HIV cured.

Postby SlyReaper » Wed Dec 15, 2010 12:16 pm UTC

At least we know it's possible now. You shouldn't underestimate how big a step it is, to find out that a thing is possible.
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Re: By the way: HIV cured.

Postby PeterCai » Wed Dec 15, 2010 1:00 pm UTC

what has religion done lately =___,=

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Re: By the way: HIV cured.

Postby SlyReaper » Wed Dec 15, 2010 1:36 pm UTC

PeterCai wrote:what has religion done lately =___,=

Stated that condoms are sometimes okay-ish under a very few specific circumstances.
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Re: By the way: HIV cured.

Postby Angua » Wed Dec 15, 2010 3:04 pm UTC

The good thing about this is that it shows that so long as you get HIV before it switches receptors (which generally doesn't happen until years after infection), a lack of CCR5 stops it in it's course. This is good as it not only offers the chance for a cure, but also a prevention, as CCR5 mutants were first identified by the fact that they didn't get HIV despite lots of high risk sexual behaviour over the course of many years. The best thing is, they are normal in every other respect, meaning hte body has a redundancy built it to compensate, so ideally if we get a drug to block CCR5 then we'll be able to both stop the disease from being spread, and cure individuals who have been newly infected! People are researching it, but I@m not sure if it's been found yet.

Hurray!
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Re: By the way: HIV cured.

Postby Sharlos » Wed Dec 15, 2010 3:56 pm UTC

Even if they could mass produce this 'cure', wouldn't it just result in the other less common strains spreading to replace it?

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Re: By the way: HIV cured.

Postby Jessica » Wed Dec 15, 2010 4:08 pm UTC

That's cool that they've proven it's possible to cure HIV. I can't wait to see the next advancement in this field.
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Re: By the way: HIV cured.

Postby Arancaytar » Wed Dec 15, 2010 5:44 pm UTC

The Reaper wrote:Oh yea, this guy. I remember this. Good on him. anti-rejection drugs are better than cancer AND aids.


Does he still need to take anti-rejection drugs if the radiation therapy destroyed his own immune system?
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Re: By the way: HIV cured.

Postby Belial » Wed Dec 15, 2010 5:48 pm UTC

Things I am not: A Doctor. But I think he would still have to take the Anti-rejection drugs to keep his new immune system from rejecting the rest of his body.
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Re: By the way: HIV cured.

Postby BlackSails » Wed Dec 15, 2010 5:58 pm UTC

It depends how good the match was, but odds are he will he immunosuppressive therapy for the rest of his life.

I believe that transplant actually shortens your life more than HIV.

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Re: By the way: HIV cured.

Postby Jessica » Wed Dec 15, 2010 6:08 pm UTC

BlackSails wrote:I believe that transplant actually shortens your life more than HIV.
Really? Sorry, but I've never heard that bone marrow transplants were that bad. It's not like an organ in the body. But, then again, not a doctor.
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Re: By the way: HIV cured.

Postby Sockmonkey » Wed Dec 15, 2010 6:38 pm UTC

Man, when I sw the title I was sure it was gonna be sarcasm referencing some nutbar in the news claiming to have cured it with voodoo acupuncture or something. Seriously, whoa.

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Re: By the way: HIV cured.

Postby SummerGlauFan » Wed Dec 15, 2010 6:59 pm UTC

Jessica wrote:
BlackSails wrote:I believe that transplant actually shortens your life more than HIV.
Really? Sorry, but I've never heard that bone marrow transplants were that bad. It's not like an organ in the body. But, then again, not a doctor.


It can be bad, since his body is now relying on a foreign immune system, but as long as he is on anti-rejection drugs his life will be longer than if he had HIV. For that matter, if it turns out his body doesn't have a conflict with the new immune cells (which is a possibility) then, to quote Zoidberg, "Life was bad, but now it's good, forever!"
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Re: By the way: HIV cured.

Postby Izawwlgood » Wed Dec 15, 2010 7:03 pm UTC

Yeah, really really awesome, for him, and promising for those who can have this done. Unfortunately, this isn't really a cure.

You know how when someone gets really bad cancer that's invaded their brain and every part of their body, and you think to yourself, well, what if we made some magic bullet that only shot the cancer cells? This guy basically had a nuke dropped on him, and miracles of modern medicine to hold him functioning. Africa's still fucked.
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Re: By the way: HIV cured.

Postby TheKrikkitWars » Wed Dec 15, 2010 7:45 pm UTC

Fucking Sick! (the guy really was when he had leukemia and HIV; and this discovery that it's possible to eradicate HIV within a still living person also is in a different sense of the word)
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Re: By the way: HIV cured.

Postby Dark567 » Wed Dec 15, 2010 8:02 pm UTC

According to wikipedia, bone marrow transplants have a %10 percent mortality. So its probably only useful in the late stages of aids when death seems pretty certain.
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Re: By the way: HIV cured.

Postby SummerGlauFan » Wed Dec 15, 2010 8:05 pm UTC

Izawwlgood wrote:Yeah, really really awesome, for him, and promising for those who can have this done. Unfortunately, this isn't really a cure.

You know how when someone gets really bad cancer that's invaded their brain and every part of their body, and you think to yourself, well, what if we made some magic bullet that only shot the cancer cells? This guy basically had a nuke dropped on him, and miracles of modern medicine to hold him functioning. Africa's still fucked.


It's still a cure, it just happens to have a metric crapton of side effects and risks. It also can't really be mass-produced, yet.

Dark567 wrote:According to wikipedia, bone marrow transplants have a %10 percent mortality. So its probably only useful in the late stages of aids when death seems pretty certain.
HIV has a 100% mortality rate. Were I infected with a disease that is guaranteed to kill me, I would probably opt for a treatment that only had a 10% chance of killing me.
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Re: By the way: HIV cured.

Postby Sockmonkey » Wed Dec 15, 2010 8:06 pm UTC

One thing to remember is that generally, once something difficult is done for the first time, proving to every one that it can be done, the psychological effect makes it far more likely that others will be able to do it too.

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Re: By the way: HIV cured.

Postby Greyarcher » Wed Dec 15, 2010 8:09 pm UTC

That's pretty awesome. Hurrah, science!
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Re: By the way: HIV cured.

Postby Dark567 » Wed Dec 15, 2010 8:15 pm UTC

SummerGlauFan wrote:] HIV has a 100% mortality rate. Were I infected with a disease that is guaranteed to kill me, I would probably opt for a treatment that only had a 10% chance of killing me.
First, it doesn't really have a 100% mortality rate, clearly people with HIV have died from things other than HIV. Second, in the developed world the current expected life span from time of infection is 32 years, assuming they start treatment relatively early. That bone marrow mortality rate is from the procedure itself. Would I prefer a 50% chance of living 32 years, or 10% chance of dying right now. There isn't any use for the treatment until the relatively late stages of HIV, its currently too risky in the early stages when the patient is almost certainly still expected to live for decades.
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Re: By the way: HIV cured.

Postby Angua » Wed Dec 15, 2010 9:41 pm UTC

SummerGlauFan wrote: HIV has a 100% mortality rate. Were I infected with a disease that is guaranteed to kill me, I would probably opt for a treatment that only had a 10% chance of killing me.
HIV doesn't have a 100% killing rate - how long you can live with it is dependent on both how well your treated, and some genetic factors which seem to stop it progressing to AIDS (I can't remember how long they've tracked those patients, but some hadn't come down with it in the time that they were being followed). You can also reasonably estimate how long someone has before they progress to full blown AIDS (without retroviral treatment I think) by looking at their viral loads in the very early stages of HIV infetction.
Dark567 wrote:According to wikipedia, bone marrow transplants have a %10 percent mortality. So its probably only useful in the late stages of aids when death seems pretty certain.

Sadly, it probably won't work then, as HIV switches the coreceptor it uses to infect cells in the later stages, and so won't need CCR5 so this treatment wouldn't work (I suppose then you might have more luck with the second receptor being blocked, but I'm not sure if that is being developed much, even though it probably is).
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Re: By the way: HIV cured.

Postby Dark567 » Wed Dec 15, 2010 9:47 pm UTC

Angua wrote:
Dark567 wrote:According to wikipedia, bone marrow transplants have a %10 percent mortality. So its probably only useful in the late stages of aids when death seems pretty certain.

Sadly, it probably won't work then, as HIV switches the coreceptor it uses to infect cells in the later stages, and so won't need CCR5 so this treatment wouldn't work (I suppose then you might have more luck with the second receptor being blocked, but I'm not sure if that is being developed much, even though it probably is).
Yeah, so basically this ends up working out to be "if you get leukemia, well we might be able to get rid of your HIV too".

Although I do think what we have learned about HIV from this may end up being pretty important.
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Re: By the way: HIV cured.

Postby Izawwlgood » Wed Dec 15, 2010 10:10 pm UTC

Actually, I just spoke to a professor about this; evidently the man he received the bone marrow transplant from had some mutation that allowed him to resist something or another.

The story here isn't that a man was cured of HIV, but that someone out there has HIV resistant T-Cells. Which is totally reminiscent of Gibsons Virtual Light.
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Re: By the way: HIV cured.

Postby The Reaper » Wed Dec 15, 2010 10:14 pm UTC

Izawwlgood wrote:Actually, I just spoke to a professor about this; evidently the man he received the bone marrow transplant from had some mutation that allowed him to resist something or another.

The story here isn't that a man was cured of HIV, but that someone out there has HIV resistant T-Cells. Which is totally reminiscent of Gibsons Virtual Light.

Not a story. We already knew that, its the same resistance that allowed europe to survive some of the black plague(the viral version). (from what I understand)

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Re: By the way: HIV cured.

Postby ++$_ » Wed Dec 15, 2010 10:18 pm UTC

Huh?

The known HIV "elite controller" alleles are HIV-specific and have nothing to do with the Plague.

That said, they are definitely a known phenomenon.

EDIT: Terminology

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Re: By the way: HIV cured.

Postby The Reaper » Wed Dec 15, 2010 10:22 pm UTC

++$_ wrote:The known HIV "elite controller" alleles are HIV-specific and have nothing to do with the Plague.

http://www.eurekalert.org/pub_releases/ ... 031005.php

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Re: By the way: HIV cured.

Postby BlackSails » Wed Dec 15, 2010 10:42 pm UTC

Izawwlgood wrote:
The story here isn't that a man was cured of HIV, but that someone out there has HIV resistant T-Cells. Which is totally reminiscent of Gibsons Virtual Light.


Thats been known for a while. There are groups of prostitutes in Africa that despite having insanely high risk for getting HIV, they dont. (Or actually, they get it, and its gone a few weeks later)

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Re: By the way: HIV cured.

Postby Izawwlgood » Wed Dec 15, 2010 10:44 pm UTC

I was under the impression that the mechanism was still unknown, and whether or not their resistance could be transferred was unknown as well. Evidently, if you're a marrow match, it can be.
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