German Doctor Cures an HIV Patient With a Bone Marrow Transplant

reporter writes "HIV is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). Until now, HIV has no cure and has led to the deaths of over 25 million people. However, a possible cure has appeared. Dr. Gero Hutter, a brilliant physician in Germany, replaced the bone marrow of an HIV patient with the bone marrow of a donor who has natural immunity to HIV. The new bone marrow in the patient then produced immune-system cells that are immune to HIV. Being unable to hijack any immune cell, the HIV has simply disappeared. The patient has been free of HIV for about 2 years. Some physicians at UCLA have developed a similar therapy and plan to commercialize it."

Comments

Like to see this replicated

[Geoffrey.landis]

I'll be really interested to see if this result can be replicated.

Re:Like to see this replicated

[Hubbell]

This is common sense to anyone with an ounce of common knowledge. There are communities and individuals all over Europe that are naturally immune ot HIV due to a mutation of the receptor on white blood cells that HIV latches onto. Common sense would tell you that hey! remove the infected patient's bone marrow, and give him bone marrow from a person who is immune to HIV. This isn't a discovery at all, it's merely the application of a common procedure in a very sensible way.

Re:Like to see this replicated

[jopsen]

Yes, cause using medical bills to force people to donate organs is a real great idea...

Personally I don't get your medical system, it sure isn't ethically responsible. Makes me glade to be a European...

Re:Like to see this replicated

[aproposofwhat]

It's true - 14% descendants of the inhabitants of the plague village of Eyam in Derbyshire, England have the mutation.

It's a beautiful little village with an excellent church and museum, if you ever get a chance to visit.

Re:Like to see this replicated

[pcolaman]

The problem with that is that you would need to administer the drug reliably on schedule for every infected person all the time and that doesn't happen. The treatments are expensive

Agree with you here, the drugs are expensive and therefore access is not widely available around the globe to these drugs.

and even worse, enough people see HIV/AIDS as some sort of punishment for promiscuity that some people are denied treatments intermittently because people don't feel comfortable giving it to them.

This is where you lost me and likely others in your argument. Show me proof that people are denied drugs based on moral grounds, or don't spout such bullshit. What you are trying to say here is people hate whores and gays, and you are trying to hide that statement in a carefully worded post. Good try but you'd have an easier time trying to convince people that JFK went into hiding and that the guy who was shot was a double. I'm not saying there aren't those people who think this way, but there's no evidence that any HIV or AIDS treatment drug that's being withheld on moral grounds. Most of the problems with getting this stuff to everyone is that, A) Most of the drugs widely available are very experimental and most of it simply doesn't work well yet or we don't know enough about how well it works, or B) It's all costly and most people cannot afford the treatments. Now if you had claimed that it's class warfare and that only the rich have easy access to that, then I'd probably be more understanding of your argument.

Re:Like to see this replicated

[Lershac]

whats it feel like to have so much in common with hitler?

Re:Like to see this replicated

[SlashBugs]

Malaria kills far more people per year than AIDS, and seems likely to keep that up for the forseeable future.

I assume that you don't have the sickle-cell anemia that gives partial protection against the malarial parasite?

OK then, I've got the bolt-cutters ready. Call my secretary and make an appointment for your sterilisation.

Re:Like to see this replicated

[des09]

Individuals and co-operating groups trying to find ways to survive and breed IS natural selection. A sterilization program is a far bigger deviation from natural selection than a bone marrow transplant, or any other treatment, with the exception of gene therapy approaches.

Besides, when did natural selection become some divine force not to be interfered with?

Furthermore, the infectious organism in a pandemic is also in a natural selection process, in this case, HIV is a very fast-mutating virus, and is almost certain to evolve a non-CCR5 binding variant before CCR5 expressive humans are selected out.

At first read I though you were just trolling, then I looked at some of your other posts, including http://slashdot.org/comments.pl?sid=1021887&cid=25678799, c'mon man, you are smarter than this?

Re:Like to see this replicated

[amorsen]

Transplanting bone marrow to a HIV-infected individual should, IMO, be followed by a mandatory sterilisation.

The exact same argument can be made about any other deadly disease with a cure. We should obviously be sterilising everyone who gets antiobiotics to cure pneumonia.

Re:Like to see this replicated

[Znork]

The same argument can be made for any medical treatment at all, ranging from flu to cancer. In fact, it can be made for most civilizational aspects, agriculture, housing, etc.

Like it or not, natural selection has been largely bypassed in civilized culture and it may not even be particularly relevant in the situation you mention, as infection rate is miniscule in many countries leading to such immunity being extremely unlikely to be a deciding factor, and certainly not a useful method for eradicating HIV.

For long-term protection against biological extinction events it's probably better to bypass natural selection on this scale anyway and keep as wide and diverse a genepool as possible. Variants that create immunity for one, treatable, disease may be susceptible to some future more dangerous plague, or vice-versa. (For example, ccr5 mediated HIV resistance has indications that it lowers resistance to other diseases such as west nile).

So it's not so much that your idea is controversial, it's just that it's not particularly, eh, useful.

Now please report to the nearest sterilization clinic and volunteer to join the fight against bad ideas. ;)

Re:Like to see this replicated

[RobertM1968]

No, I believe arth1 is just stating a scientific fact/theory that in such epidemics, that can often be the normal course of things. That doesn't in any way indicate whether he thinks it a viable solution to the problem, a happy one a moral one or whatever.

Haven't you ever watched Star Trek (TOS)? Just imagine Spock stating a logical conclusion to a given scenario. You dont have to like it, but it doesnt mean he agrees that it is the best solution - it's just a statement of the outcome as it would occur under a set of given circumstances.

I have yet to comprehend why when people dont like a (true) answer, that they need to pick apart the semantics and try to apply implications to the words that were not there. Evolution and many aspects of life, as they happen, even without human interference; are rarely concerned with the morality of the outcome. People who state such are not necessarily amoral, wrong or bad.

Robert

Re:Like to see this replicated

[ultranova]

Transplanting bone marrow to a HIV-infected individual should, IMO, be followed by a mandatory sterilisation. Else, we will be working against natural selection, and will in the long run assist HIV in surviving by increasing the number of non-resistant individuals in future populations.

This is not only stupid but also logically absurd, for reasons outlined below.

First of all, HIV-immune people appear to compose some 1 percent of the population, at maximum. That means that you'd be culling 99% of genetic variations from humanity, leaving the remainder much more genetically uniform and thus vulnerable for the next pandemic. And let's not forget that "immunity to HIV" is not like a feat in a role-playing game; it is a result of the particulars of your biochemistry, and likely has side effects, such as extra vulnerability to some other disease.

Secondly, if bone marrow transplantation makes you immune, then having no inherent, natural immunity isn't significant - everyone who gets infected gets cured and HIV will run out of hosts and die out. Being vulnerable to a treatable illness is hardly rational grounds for sterilization.

Thirdly, why treat HIV specially ? There are lots of deadly diseases out there. Should we sterilize everyone who is not immune to any one of them - which, I'd hazard to guess, would mean sterilizing everyone ?

Finally, it is impossible to interfere with natural selection. Natural selection means that the fittest have most descendants, and fitness is defined as having lots of descendants. "Survival of the fittest" is a tautology, you can't alter it. The only thing you can do is alter the environment, which then alter which characteristics make you fit.

Frankly, I'm beginning to see the merit in removing evolution from school curriculum and replacing it with creationism or whatever. We've seen crap like this since when the theory was first introduced; while some of it was purposeful, at least some had to have been caused by honest stupidity. Only teaching it on university level might act as a filter to keep it away from people who'll figure it means they should start an eugenics program.

Re:Like to see this replicated

[timeOday]

Did you actually read arth1's whole comment? The first part was an objective prediction about evolutionary dynamics. The second part was this: "Transplanting bone marrow to a HIV-infected individual should, IMO, be followed by a mandatory sterilisation."

Re:Like to see this replicated

[joocemann]

HIV is not the cause of AIDS...
AIDS has failed to move out of the 'high risk' groups, in over 25 years...
The number of 'HIV positive' CASES in Western countries has failed to increase year upon year...
(Obviously the TOTAL of so-called 'HIV positive' people has increased each year, because the cases are counted CUMULATIVELY, unlike every other disease. Cancer for example...)
STD cases are rising every year (NON-CUMULATIVE figures, of course), yet where are all the teenagers dying from 'AIDS'?
Up to one third of people who are 'HIV positive' don't KNOW they are 'HIV positive', and therefore cannot be taking any of the so-called 'medications', which allegedly keep 'HIV positive' people alive. Why aren't they dropping like flies? This is hundreds of thousands of people in the U.S. alone. Why aren't they spreading the 'deadly virus' like wildfire, since they don't know they have it, and other STDs are spreading like wildfire?

Read the book 'Science sold out'.

HIV and AIDS 'research' are the biggest example of modern scientific fraud ever perpetrated on the people of this planet by the pharmaceutical companies and phoney 'researchers'...

Cue pathetic responses from Slashdotters who know sod all about HIV and AIDS, ignore the real world evidence that proves there is no such thing as 'HIV', and that AIDS is not sexually transmitted...

You are full of shit.

Re:Like to see this replicated

[Anonymous Coward]

You seem confident. Now would you have unprotected sex with an HIV+ person multiple times a week over the course of a year to prove your hypothesis?

I doubt it...

Re:Like to see this replicated

[lysergic.acid]

cherry pick all you want. AIDS/HIV sufferers being denied treatment because of societal prejudices is well-documented. whether it's drug users, prostitutes, rape victims, or just ordinary women with HIV, people are being denied AIDS/HIV treatment because of the social stigma around these populations and their perceived lifestyles.

it's ignorant attitudes like yours that cause these prejudices to dictate public policy at the expense of public health. even if you don't care whether IV drug users live or die, giving them access to medical treatment in the name of harm-reduction is the beneficial to society at large. any rational person can see that eliminating potential disease vectors is a good thing.

denying prostitutes & drug users adequate access to medical treatment in order to punish them for their lifestyles is just cutting off the nose to spite the face. that kind of attitude has prevented the adoption of needle exchange programs in many areas despite studies showing that such harm-reduction programs save cities tax-payers millions of dollars each year by preventing the spread of disease--which inevitably affects non-drug users as well.

Re:Like to see this replicated

[lysergic.acid]

in many states you still need a prescription to get "Plan B"/"morning after pill"-type emergency contraceptives. which is dumb because there's a limited window of effectiveness for those type of drugs.

though there is a growing movement in the U.S. to make these drugs available over the counter. according to Wikipedia a nonprescription behind-the-counter preparation of Plan B is available in California to women 18 years or older. this was supposed to have been put into effect in 2006, but i haven't heard much about it. i just know that about 2-3 years ago my gf at the time had to get her prescriptions from a rapid-approval website, and (i think) it took about 6 hours between filling out the online and actually getting the prescription filled at a local pharmacy.

and if you don't like the idea of the conscience clause you're not alone. unfortunately, freedom of religion in the U.S. has turned into freedom to subject others to your religion. that's what happens when separation of church and state is flouted by a society. it starts with relatively innocuous things like adding "in god we trust" to our currency and injecting theocratic sentiments into the pledge of allegiance, but then quickly spreads to more insidious things, like encroaching on the rights of patients.

Re:Like to see this replicated

[lysergic.acid]

if your religion prevents you from performing the responsibilities of a medical professional, then you probably shouldn't be a doctor/nurse/pharmacist/etc. and AFAIK, pharmacists can quit their jobs or switch to a different occupation any time they want. no one is forcing them to be a pharmacist.

if you think that your religious freedoms include the right to deny someone else the medication they've been prescribed by their physician, then you are part of the reason why the conscience clause exists. freedom/liberty doesn't mean you have the right to do whatever you want regardless of the consequences it has on others.

and by your definition of slavery, then anyone living in a society governed by the rule of law is a slave. drug/food manufacturers all have to obey by strict sanitation and food-safety regulations even though they may not want to, but that's what it takes to protect consumers and public health. occupations like law enforcement and medical professions have even greater social responsibilities due to the vital nature of their work. if an on duty police officer sees a crime in progress they have a legal responsibility to step in, otherwise it may be criminal negligence. likewise, medical professional have certain moral obligations when they are on duty.

Re:Like to see this replicated

[Rary]

Ok, first of all, emergency contraceptive pills are not prescribed drugs. Anyone can go to a pharmacy and get them over the shelf!

Well, sort of. Many places still refuse to take them out from behind the counter, and they insist on putting the patient through an "interview" before allowing them to purchase the drug. I'm not sure if they'll actually deny them the drug if they're not happy with the answers to the questions.

Second, if I read your post right, the idea that a pharmacist has the authority to deny me drugs that a doctor prescribed, based soly on their religious beliefs is complete and utter bullshit!

It is absolutely bullshit. And yet it happens.

Re:Like to see this replicated

[DamnStupidElf]

It's not "subjecting others to your religion". It's denial, and it's an important part of voluntary human relations. It simply doesn't matter if religion is behind it. Forcing doctors to perform procedures against their will is slavery.

A license to become a doctor or pharmacist implies putting the patient's interests first and following well established medical guidelines. If abortion, birth control, or euthanasia is what the patient wants, the *licensed* professions had better do their job or lose their license.

Would you license an engineer who wouldn't walk under ladders or go to the 13th floor to perform inspections, or who insisted the best way to keep a bridge standing was by throwing salt over his shoulder every day? Licensed professionals denying birth control is just as silly.

Re:Like to see this replicated

[olman]

I dunno ... is she really hot?

Or more to the point, worth dying for?

Re:Like to see this replicated

[Anonymous Coward]

The fact that this "rebuttal" is modded +4 insightful is proof the /. moderation system is broken. Let's try to keep agreement out of the equation please.

Re:Like to see this replicated

[garyebickford]

if your religion prevents you from performing the responsibilities of a medical professional, then you probably shouldn't be a doctor/nurse/pharmacist/etc. and AFAIK, pharmacists can quit their jobs or switch to a different occupation any time they want. no one is forcing them to be a pharmacist.

if you think that your religious freedoms include the right to deny someone else the medication they've been prescribed by their physician, then you are part of the reason why the conscience clause exists. freedom/liberty doesn't mean you have the right to do whatever you want regardless of the consequences it has on others.

Using your reasoning, then if the government enacts a law that violates your conscience, you should give up your career? My understanding of the principles of law is that we are obligated to put conscience above the law. For example, in the Nuremberg trials, various Germans were convicted despite "just following orders". Then there are also many instances of medical research (a very little bit of which was actually quite valuable) in many countries including the US, that involved the torture or death of subjects. Many of those who participated in such research have been brought to justice 30, 40, 50, and 60 years later.

For a specific example, in many cultures at one time or another, infants were 'tested' at the time of birth in various ways, and allowed to die if they didn't meet societal criteria for survival. Other societies did not give infants names until they were two years old, as so many of them died. Therefore, it is entirely possible that some government in the future would enact such laws. One side of the argument about partial birth abortion is that it is a present case of live-birth infanticide. So if the government should enact a law allowing all infants that don't meet some criteria for health or fitness to be killed (by whatever means), should the physician, nurses and aides all participate?

It seems to me that you are arguing that a doctor or pharmacist who is faced with participating in such horrific (from most people's point of view) practices should either proceed, or quietly go away, leaving the government to proceed with impunity. Or, in the case of a pharmacist, if a doctor were to prescribe an lethal overdose of painkiller (for whatever reason), then the pharmacist's obligation (perhaps after checking with the doctor) would be either to prescribe it or to quit the business.

I think you have confused conscience with desire. These professionals are not doing this because it is fun; they are doing it because they believe it is unethical, possibly illegal, and wrong. I think it was Patrick Henry who said, "Liberty is not the freedom to do what you want; it is the freedom to do what you must." Those medical professionals who refuse to participate in immoral acts out of conscience are following that principle. They are doing it because they must. If you disagree with them, then you are free to argue the case, but don't dismiss them out of hand.

So you need immune bone marrow?

[Krupuk]

Is there a way to create or replicate this bone marrow? Or will this immune donor be continually used for every AIDS patient in the world? How many natural immune donors are there? I think only a few. But still interesting.

I know what bone marrow transplants do to people

[haaz]

My late mother had a bone marrow transplant (BMT) to treat her pre-leukemic condition and try to prevent it from becoming full-bore leukemia. To do this, they blasted her whole body with radiation (sorry, don't know which frequency), which killed her existing bone marrow. They then inserted/transplanted his sister's bone marrow. Now, I am not a doctor, so I'm probably leaving out a lot of important steps here. But because of the radiation dosage, she lost her hair, a lot of weight, and the ability to keep food in her for any length of time.

Yes, we knew this was coming. In fact, she had worked as a radiation oncologist for decades before her diagnosis with myelodysplasia. The irony abound.

Unfortunately, either the transplant didn't take or the weakness was too much for her. She passed away on November 16, 1999. Two weeks after I'd gotten married. And some of you may remember my then-wife from what happened five months later. Yeah, life kinda sucked.

I do want to see the HIV/AIDS pandemic curbed, and I do what I can to help people who have it live a little better. But a BMT is a major, major procedure. It's not guaranteed to be a death sentence, but it's not guaranteed to work, either. Is it worse than HIV/AIDS? That question is beyond my pay level to try and answer. I just have one story from one BMT that unfortunately did not go well. I am thankful that no one in my family has had HIV/AIDS. But I just don't know if this is the best way to deal with it once someone is infected.

Re:Nice to hear....

[FooAtWFU]

Leave it to a U.S. institution to be concerned with profiting from a possible cure for HIV.

Sure, I'll leave it to them to do that, if you'll at least leave it to a US institution to invest in a ton of experimentation, research, development, refinement of the techniques, overcoming regulatory hurdles, patient trials...

30% mortality rate

[slashing1]

The article mentions that the mortality rate from this procedure is 30%, which precludes widespread replication as it is only used in late-stage cancer patients. Thus, while the CCR5 mutation is promising, they need another method (besides bone marrow transplant) to deliver the therapy. This leads to gene therapy, but that has other issues (such as causing leukemia as a side effect).

Side effects of bone marrow transplant

[NigelTheFrog]

Ok, I'll admit this sounds like a neat concept for curing someone with HIV, but wouldn't you just be trading all of the consequences of having HIV/AIDS for the consequences of being a bone marrow transplant recipient? One of the most feared complications of bone marrow transplantation is graft-versus-host disease. The treatment for GVHD is...immunosuppression. So HIV patients who receive this treatment would have to face the possibility of being no better off than they were pre-treatment and potentially much, much worse (graft vs-host is a horrible condition).

Re:Monetization

[ScrewMaster]

It's all pure greed.

Partly greed, I suppose, and partly because the resources being devoted to HIV/AIDS research aren't free, and other important venues are being underfunded or defunded. Resources are limited, no matter where you are, and public health isn't about dealing with only the medical conditions that get the most media attention. AIDS is not like, say, a food-borne illness that can strike anyone at any time, and there are people suffering from other serious ailments than AIDS.

Re:Evolution.

[Thomas M Hughes]

Unless, by curing HIV, we're putting a halt to the next stage in human evolution. It could be that HIV was intended to trigger a dormant subsection of our genome.

HIV doesn't have intentions. It's a virus, not a God.

Re:Evolution.

[Anonymous Coward]

Hmm... you used the words 'Evolution' and 'intended' in the same post.

Re:Nice to hear....

[Anonymous Coward]

You know, i wish people like you would get over it. It costs money to live. Doctors and researches need to get paid. It is precisely because of this that we have the innovations we have in medicines.