H.I.V. is reported Cured in a Second Patient

[ch33zw1z]

https://www.nytimes.com/2019/03/04/health/aids-cure-london-patient.html

Could it be? That would be pretty amazing for many people

 

[interchange]

I'm not sure this portends much for the future. A bone marrow transplant is generally riskier than living with HIV.

 

[zinfamous]

Yeah, the guy almost died a few times in the process, and the procedure is absurdly expensive--something like $1 million just to do the testing to find a proper donor.

I see this procedure as sort of an end-around to clinical trials on proving that your target receptor works--this is the kind of experiment that you can do freely with model animals, but humans is well, never going to be improved--you find a person that is HIV immune...but no medical board is ever going to approve inoculating that person with HIV. ...but you find someone that is HIV positive and essentially make them immune by replacing their lymphocytes with those of an immune individual, it's essentially the same test.

 

[MomentsofSanity]

This isn’t as promising as it seems. The same stem cell procedure was tried in many other HIV patients with no results. It appears it’s only effective on a very small percentage of patients.

Add to that the fact that it’s incredibly risky as it was done in concert with chemotherapy and the fact that the current treatments are already very effective I don’t think this will hold much future promise. What It does do is show that the previous patient in Germany years earlier was not an anomaly. Perhaps it may lead to some possible treatment therapies down the road.

 

[Commodus]

This isn’t as promising as it seems. The same stem cell procedure was tried in many other HIV patients with no results. It appears it’s only effective on a very small percentage of patients.

Add to that the fact that it’s incredibly risky as it was done in concert with chemotherapy and the fact that the current treatments are already very effective I don’t think this will hold much future promise. What It does do is show that the previous patient in Germany years earlier was not an anomaly. Perhaps it may lead to some possible treatment therapies down the road.

The main thing is that you need someone who both has a very rare genetic mutation and happens to be an immunological match... it's like winning the lottery, and you might have better odds of winning the lottery.

More than anything, this suggests that gene editing could work as a treatment down the line.

 

[Indus]

While some HIV infected people tend to die within 5 years (sadly the majority).. things have also progressed to the point where people like Magic Johnson can live long productive healthy lives. Those life saving drugs/ treatments are more viable but they have to be a reasonable cost.

 

[interchange]

While some HIV infected people tend to die within 5 years (sadly the majority).. things have also progressed to the point where people like Magic Johnson can live long productive healthy lives. Those life saving drugs/ treatments are more viable but they have to be a reasonable cost.

Where the hell are you getting your information from? Incubation time alone is greater than 5 years.

 

[zinfamous]

While some HIV infected people tend to die within 5 years (sadly the majority).. things have also progressed to the point where people like Magic Johnson can live long productive healthy lives. Those life saving drugs/ treatments are more viable but they have to be a reasonable cost.

Technically, with access to the popular cocktails these days, no one really dies of HIV anymore. In the First World, it's actually now extremely rare--I actually think impossible?--to develop AIDs as long as you have proper treatment.

I wonder if that number you are reporting is a world-wide figure that includes large populations, where AIDs is still a serious problem, that have little-to-no access to modern treatment? That is definitely a horrible thing and its own thing, but in practice, HIV is no longer a death sentence, and as long as one is on medication, there is little worry of even transferring HIV to a healthy individual.

 

[Indus]

Where the hell are you getting your information from? Incubation time alone is greater than 5 years.

From my wife.

In her native country, HIV/ Aids related deaths are a major problem. Which unfortunately is due to the culture of not having yearly physicals as a routine.

When people usually do go to the doctor/ hospital with symptoms, its already advanced and death is within 5 years.

 

[interchange]

From my wife.

In her native country, HIV/ Aids related deaths are a major problem. Which unfortunately is due to the culture of not having yearly physicals as a routine.

When people usually do go to the doctor/ hospital with symptoms, its already advanced and death is within 5 years.

Ok. Well symptom onset and time of infection are vastly different things. And of course access to treatment is very different depending on where you live. I live in a major city in the US with high HIV infection rates. I see a lot of patients with HIV. Availability of treatment and efficacy of treatment is not the problem here, but I don't know how that compares elsewhere, particularly rural areas. You might be surprised, though, that there are many people who are knowingly having unprotected sex with HIV infected individuals, have access to free care but never get established, have no significant side effects to treatment yet don't take it, etc. The human mind is truly amazing and truly tragic. The amount of self-destruction in the world is staggering, and I find very few people who empathize with it. Much easier to call people stupid for making self-destructive choices.

 

[Indus]

Ok. Well symptom onset and time of infection are vastly different things. And of course access to treatment is very different depending on where you live. I live in a major city in the US with high HIV infection rates. I see a lot of patients with HIV. Availability of treatment and efficacy of treatment is not the problem here, but I don't know how that compares elsewhere, particularly rural areas. You might be surprised, though, that there are many people who are knowingly having unprotected sex with HIV infected individuals, have access to free care but never get established, have no significant side effects to treatment yet don't take it, etc. The human mind is truly amazing and truly tragic. The amount of self-destruction in the world is staggering, and I find very few people who empathize with it. Much easier to call people stupid for making self-destructive choices.

Oh I believe it.

I have interacted with a lot of people to who unprotected sex with multiple partners is pretty much like going to the bathroom. Often its also a way of survival sex.. sex for a few dollars or something so little as much as a bowl of ramen noodles and an overnight place to sleep.

 

[zinfamous]

From my wife.

In her native country, HIV/ Aids related deaths are a major problem. Which unfortunately is due to the culture of not having yearly physicals as a routine.

When people usually do go to the doctor/ hospital with symptoms, its already advanced and death is within 5 years.

right, so it has nothing to do with the disease an how treatable it is, but this is entirely due to socioeconomic factors of the region.

 

[darkswordsman17]

The disparity between how NYT and Ars reported on this is...interesting:
https://arstechnica.com/science/201...v-resistant-stem-cells-cures-another-patient/

Ars really didn't delve into the severity of the treatment, which I'm not sure if it was because they were kinda more focused on the scientific aspect, or if they just assumed people knew how severe those treatments are (which knowing people that have done serious healthcare treatments, cancer/chemo, heart transplants, etc, what that guy went through was pretty crazy).

Just realized, it was the first guy that had it so severe. That's not to dismiss what this 2nd one went through, as it certainly was no cake walk I'm sure, but it is a definite advancement in relative horribleness of what they experienced.

Which looking at the comments on the Ars article, seems like we're seeing the potential of stem cells (someone mentioned that similar immunosuppression mixed with stem cell treatments helped with other debilitating stuff). Certainly not perfect (since they try it with many more people and it doesn't work for most), but the more it happens, the more we can potentially figure out why and improve it.

But I also know that we're looking at a future firestorm, especially in the US.

Also, the situation with Truvada, where because of the patent its tens of thousands of dollars per year for it in the US, while the UK said fuck the patent because it was such a good (you know, helping to prevent people potentially dying and spreading such a horrible disease because they can't afford the exorbitant cost).

 

[interchange]

I mean... There is perhaps potential for gene therapy to modify adult stem cells from the same individual to do the treatment, at least bypassing the need for immunosuppressive therapy afterward. Not sure you'd need to eradicate someone's existing immune system to successfully have proliferation of the stem cell transplant. Anyway, that kind of treatment concept is applicable to a lot more than HIV, but I have no idea how far off on the horizon such a treatment might be.

 

[esquared]

Finding that select, donor is rare. Looks to have a double mutation of a gene (CCR5) that prevent attachment of HIV to the T-cells.
https://www.npr.org/sections/health...transplant-renders-second-patient-free-of-hiv
"The doctors selected a donor who had two copies of a particular mutation in the CCR5 gene that prevents HIV from infecting T-cells, a part of the immune system where the virus takes hold and does its damage. As a result, the man ended up with an immune system that was naturally resistant to HIV. "

Incidentally, that is the same gene, CCR5, that the Chinese scientist edited on those embryos that ended up making the
twins, allegedly, resistant to HIV infection.
https://www.npr.org/sections/health...ist-says-hes-first-to-genetically-edit-babies
"For their research, He and his colleagues say they used CRISPR to make changes in one-day old embryos in a gene called CCR5. The CCR5 gene enables HIV to enter and infect immune system cells. Scientists have long searched for ways to block this pathway to protect people from HIV."

Zin's the geneticist. He can elaborate, if he wishes. 😛

edit:
I read the whole article from the OP and it appears that they have a database of 22,000 people/donors with this mutation.

 

[kitkat22]

Actually, patient's with HIV who regularly take their medications can live a full productive life with only a few years off the life expectancy. In the 80s, prior to HART, patient's would typically survive about 5-10 years. (I know because my brother was one of them.) The caveat of course is access to the right medications and treatment.

https://www.researchgate.net/figure...etroviral-therapy-in-2000-8-by_fig2_232269759
http://www.thebodypro.com/content/66391/life-expectancy-increases-for-north-americans-livi.html

 

[Hayabusa Rider]

From my wife.

In her native country, HIV/ Aids related deaths are a major problem. Which unfortunately is due to the culture of not having yearly physicals as a routine.

When people usually do go to the doctor/ hospital with symptoms, its already advanced and death is within 5 years.

What culture? Where?

 

[K1052]

Another case is interesting but kind of besides to the point when we actually have the tools now to eradicate HIV inside the US within a generation or two as it is. We've simply decided not to do that.

 

[whm1974]

Another case is interesting but kind of besides to the point when we actually have the tools now to eradicate HIV inside the US within a generation or two as it is. We've simply decided not to do that.

Citation Please.

 

[K1052]

Citation Please.

We have rapid testing, effective retroviral therapy, and pre exposure medication. The failure to fully and comprehensively utilize these tools is a policy decision. As is the prohibition on supervised injection sites and needle exchanges (still in place in some states) to dramatically reduce iv drug user rates and get them into testing/treatment regimes.

We're making choices to sustain the disease.

 

[whm1974]

We have rapid testing, effective retroviral therapy, and pre exposure medication. The failure to fully and comprehensively utilize these tools is a policy decision. As is the prohibition on supervised injection sites and needle exchanges (still in place in some states) to dramatically reduce iv drug user rates and get them into testing/treatment regimes.

We're making choices to sustain the disease.

Yeah we should be using Public Health measure that have been shown to work.