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

[Anonymous Coward]

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

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

Re:Like to see this replicated

[ScrewMaster]

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

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

I've been expecting something like this ever since the discovery of HIV-immune individuals. So yes, the donor can be replicated.

Re:Like to see this replicated

[MSTCrow5429]

With the severely limited number of people with known immunity to HIV, and the pain of removing bone marrow, I'm wondering if more than a mere handful of people can be treated via this method.

Re:Like to see this replicated

[Chaos Incarnate]

Couldn't the recipients, who will generate the new bone marrow, then be used as donors?

Re:Like to see this replicated

[eln]

Right now, there's a ban on selling organs for donation in this country. However, bone marrow transplants are expensive. If the recipient could later be used as a donor, the ability to pay them for their marrow (thus allowing them to more easily pay for the original transplant) could really help move this thing along. Even if a marrow recipient is reluctant to donate his own marrow, if he had a very large medical bill and was offered money to donate, he would be much more likely to do so.

Of course, given the limited number of naturally HIV-immune people in existence today, it would drive up the price of a transplant in the short term as they demand high prices for their marrow, but in the long run it would even out as we create more HIV-immune people.

Re:Like to see this replicated

[DebateG]

I think the end goal is to use this method for autologous stem cell transplant (when the donor is the same as the recipient) rather than allogeneic (when the donor is different). Currently, there are technologies such as small interfering RNA (siRNA) that let you suppress a specific gene through genetic engineering. They are widely used in research, although there are many hurdles before they make the transition to clinical use. It would go something like this:

1. Draw out someone's own stem cells
2. Permanently express the CCR5 siRNA in their stem cells by culturing them with a virus
3. Wipe the person's bone marrow out by total body irradiation
4. Reinfuse the altered stem cells

The advantage of this method is that, since the stem cells are coming from your own body, there is no graft vs host disease (which is essentially like standard organ rejection, but instead the organ rejected is your entire body being rejected by the graft... you can imagine that this is very bad). Of course, you still have the problem of developing leukemia later from the total body irradiation and viral integration into an important gene. You also have a high risk of death upfront when you spend several weeks without a functional immune system when the transplant is taking. But nevertheless, it's exciting.

Re:Like to see this replicated

[Cyberax]

On the contrary, bone marrow transplants are the cheapest transplants.

In essence, bone marrow transplantation is just an intravenous injection.

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

[jcr]

One thing I've been wondering about is whether it would be possible to fight infection just by making a protein that binds to CCR5 and does nothing else. I'm presuming that HIV can't attach to the receptor if there's something in the way.

Would any molecular biologist reading this please tell me if this works or not?

-jcr

Re:Like to see this replicated

[TheoMurpse]

I seem to recall a lecturer visiting my hometown's community college and giving a genetics lecture. During the lecture he claimed that the plague caused a lot of people with the CCR5 receptor that HIV attacks to die off (the plague also attacks CCR5, allegedly), thus creating a non-trivial population of northwestern Europeans who are immune to HIV.

What's the current status of this theory? Google returns quite a few hits, but as I'm not a geneticist, and technically haven't taken a biology class in 13 years, I'm not that qualified to filter out bunk.

Re:Like to see this replicated

[geckipede]

That's how some of the new drug treatments for HIV work. The article mentions them. Are you suggesting a form of genetic treatment where you don't remove the surface protein from existing cells but add more cells that produce blocking drugs?

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

[jcr]

I wasn't suggesting any particular way of administering the blocking proteins, just wondering whether it was a viable strategy.

-jcr

Re:Like to see this replicated

[Anpheus]

Can you throw a little House into that? Like, say autoimmune a few times, maybe "at least it isn't lupus" or something? Amyloidosis?

Re:Like to see this replicated

[Pax681]

IIRC i watched a TV doc about HIV immunity and how it was found. there is a link to the black death here too.

AS it was discovered that the very same genes that help immunity from the black death are same for HIV.

if you have none of this gene pair "switched on" then you are gonna get ill quick and die......

if you have one of the pair on then you will go on for a few weeks THEN come down with symptoms.

However with BOTH genes switched on you are immune but carry the black death/HIV virus. Was on the discovery channel....

It was also apparently found that is was only ethnic Europeans who had this gene switched on... this led to some conspiracy theories about HIV/AIDS being created to be targeted at non whites.

NEVER let it be said that a late night spliff to chill out whilst Discovery is on is a waste of your chill time!

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

[SlashBugs]

Background for non-biologists: HIV typically gains entry to cells by binding two molecules on the healthy cell surface. These are CXCR4 and CCR5. About 1% of white males (other genders/races vary slightly) don't have CCR5; they seem completely healthy and their cells are highly resistant to HIV infection. So blocking the activity of CCR5 seems like an easy way to stop viral infection with no exprected side effects. Tricky to do, but probably worth the effort.

Anyway, the answer is "yes", sort of. Several antibodies and small peptides are in trials to block the CCR5 receptor; some are showing promise in animal trials.

The most famous is Maraviroc, a small molecule that binds CCR5 and stops is from binding HIV. It's sold by Pfizer and currently in use as an anti-HIV drug.

Another interesting possibility is gene therapy. Another group has recently made CD4 T cells (one of the cell types that HIV infects) express a small molecule to block their own CCR5 receptors, which works very well. I haven't seen a paper on it, but you should also be able to use similar techniques to completely shut down CCR5 production (using virus- or plasmid-borne shRNA, for example).

Finally, another group has managed to make rabbits produce antibodies against CCR5 receptors (Vaccine
Volume 26, Issue 45, 23 October 2008, Pages 5752-5759). Those antibodies are able to bind to CCR5 and completely block HIV infection, which is great. Stimulating an immune response against the patient's own immune cells sound a bit dodgey to me, but my immunology isn't great: maybe there's a well-established way around this problem that I just don't know about.

Re:Like to see this replicated

[geckipede]

Most of the drug treatments seemed like a viable strategy at one point. HIV mutates extremely rapidly though, and it seems able to bypass almost anything we can throw at it. If the new types of drugs can reduce the virus's ability to replicate effectively enough that it doesn't get an opportunity evolve a way round then in theory it could work. 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, 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.

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

[Thiez]

> Because this trait appears to be genetically inheritable, unless well-meaning doctors interfere by transplanting bone marrow, the donors will be replicated. Natural selection will favour those resistant to HIV infections, and within a few generations, people with this survival trait will have produced noticeably more offspring. Of course, this is of little value to those who would develop AIDS or other HIV-related diseases in the mean time...

I don't think so. Selection for the HIV-immunity gene is very weak, since very few people have HIV. Now if we were to stop using drugs against HIV and all have unprotected sex, then natural selection would kick in properly and the gene would spread. Then again, having this gene may not be that great. Maybe having it increases chances of getting some other, even more vicious disease (although it wouldn't be the first time useless genes/organs/bones/whatever are found, so maybe there are no downsides to having the HIV-immunity gene).

> 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.

Ah, but where to stop? I guess we should also sterilise blind people, deaf people, people with diabetes, etc. While removing people with bad genes from the gene pool would fix many genetic defects for generations to come (obviously), most people would agree it may not be the right thing to do.

Re:Like to see this replicated

[Thiez]

Just because Hitler did something doesn't make it bad. I'm sure Hitler ate and drank, but does that make you a nazi when you have breakfast?

Re:Like to see this replicated

[Lershac]

Weellll specifically ole Hitlers attempts to genetically purify mankind by removing classes of people are what is most hated about him... and thats what arth1 is proposing...

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

[SlashBugs]

Depends how you choose to express the siRNA.

Plasmids are generally pretty safe, if you pick one with decent copy-number control. Something like Epstein Barr virus' dormant plasmid would be pretty good, as it automatically keeps itself to just a few copies of itself per cell and constantly expresses a couple of RNA molecules. Just remove the viral genes and throw your shRNA in there under the same promoter... should work like a charm.

There are also some viruses that always integrate into a specific, safe part of the genome. Adeno-associated virus, for example, always slots itself into the same site (somewhere on chromosome 19 IIRC?) and lies dormant. It has a tiny capacity for payload genes so is often ignored, but if you just want to express a few shRNAs it's be ideal.

But yes, the radiation will still be a bitch. I've seen several patients going through it, who all agree that the treatment is better than the disease, but only just.

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

[FrkyD]

true, just like the quaint idea that medical care shouldn't bankrupt you.
Speaking as an American that's lived on both sides of the pond, with a mother in the states being nearly bankrupted by her cancer treatment and a mother-in-law in europe who had the same level of care with no added costs, I know which system I prefer.

Re:Like to see this replicated

[andot]

Bone marrow removing is not very painful. It basically chemotherapy and all needed cells are collected from blood not from bones. I have been bone marrow donor for myself. Read about it http://rarediseases.about.com/od/rarediseasesb/a/bmt05.htm

Re:Like to see this replicated

[Anonymous Coward]

Damn, the guys who are HIV immune must be ecstatic!
They are instantly the most popular people in the bar!

"Yo baby, i have HIV immunity"

Re:Like to see this replicated

[SlashBugs]

If it makes you feel better, I'm at the end of a PhD in the field. So I know more about HIV and AIDS than most of the population and, indeed, am one of the "phoney researchers" who generates the same data that I am, apparrantly, ignoring.

Tell us - what's your Ph.D. in?

Try getting your science from reputable schools or journals rather than mass-market paperbacks.

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

[Khyber]

Black Death is not a virus. It is a bacterium. Yersinia pestis.

Re:Like to see this replicated

[lysergic.acid]

or you could do a little research yourself before running your mouth off.

in the U.S. there are also conscience clauses in several states that allow pharmacists to refuse to fill a patent's prescription based on religious grounds. this was primarily introduced to to deny women emergency contraceptive pills, but it also opens the door for denying patients other types of medical treatment based on religious prejudices.

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

[blitziod]

dude bone marrow is collected then cultured. you take a little from a donor then grow it. you really only need a few donors to produce a lot over time.

Re:Like to see this replicated

[radtea]

Why bother wiping out the existing bone marrow?

This isn't like leukemia, where we want to kill all the abnormal cells. The patient's existing marrow is perfectly healthy, and its presence or absence will have no effect on the ability of the donor cells to colonized the liver or where-ever it is that they typically wind up.

So the patient shouldn't need any radiation at all. Their unmodified marrow will still produce T cells that are susceptible to the virus, but that's no big deal because the T cells from the modified marrow will be able to handle it.

Maybe I'm missing something, but it seems at least possible that one could do this with a "marrow plant" rather than a "marrow transplant".

Re:Like to see this replicated

[swillden]

On the contrary, bone marrow transplants are the cheapest transplants.

In essence, bone marrow transplantation is just an intravenous injection.

This is accurate, but misleading. Bone marrow transplants are cheap as transplants go, but they're still very expensive. The IV injection of the transplant is no big deal, but before it can be done the recipient's own marrow must be destroyed by chemotherapy or radiation treatments, and after the transplant the patient has to be on immunosuppresives and receive regular transfusions until the new bone marrow can establish itself. During that time, the patient also has no immune system, and must be in a hospital or other sterile environment.

The whole process takes 1-2 months, and is far from cheap.

Re:Like to see this replicated

[ScrewMaster]

What they may be referring to is the fact that one prominent researcher's study came to the conclusion that HIV was not highly correlated to AIDS which suggested that HIV was not the causing the AIDS. Immediately he was kicked out of the scientific community as they stated that he should be jailed for life for trying to disprove a current hypothesis (which is the point of being scientific).

Are you talking about Peter Duesberg, by any chance?

Re:Like to see this replicated

[ScrewMaster]

Just because Hitler did something doesn't make it bad. I'm sure Hitler ate and drank, but does that make you a nazi when you have breakfast?

Yes, yes it does.

Re:Like to see this replicated

[tsotha]

I'm not sure a form to submit complaints really buttresses your argument. I've never heard of an instance in the US where someone was denied medication for HIV for any reason. Not even money. I'm sure it's happened, just because with a large enough sample group you'll get any behavior you can imagine. But it's a small enough chance as to be functionally zero. In most places a pharmacist who refused to provide a lifesaving drug for pretty much anything would be run out of town even before the government started in on him.

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

[Anonymous Coward]

I can't comment on the relative cost of a BMT to other types of transplants, but to say that a BMT is just an intravenous injection is completely misleading.

An (allogeneic) BMT is essentially the replacement of a recipient's immune system with the immune system of a donor. Before implanting the donor's immune system (which literally is an IV infusion of hemapoetic stem cells) the recipient's own immune system has to be destroyed. This is done with high-dose, whole-body radiation and high-dose chemotherapy, which have numerous, serious side effects. Once the recipient's immune system is destroyed (the treatment's intended effect) they are at extremely high risk of contracting potentially-fatal infections, and for this reason they are hospitalized in special 'clean' BMT units with extremely close monitoring for an extended period of time. It takes many weeks before the transplant (hopefully) engrafts, and then many more months before the new immune system is fully functioning. Once engraftment occurs there is high-probability of acquiring graft-versus-host (GVH) disease (potentially fatal) and this is managed through the use of immunosupressants and close monitoring as an outpatient for many months after the transplant. The good news here is that the immune system usually becomes tolerant of the recipient's body (the graft sees all of the host's tissue as foreign) and the immunosuppressants are eventually not needed, unlike the case for organ transplants.

So is a BMT just an intravenous injection? I think not.

I'm speaking from personal experience; my daughter recently underwent a BMT. The cost? approaching $1M.

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

[ScrewMaster]

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...

I dunno ... is she really hot?

Re:Like to see this replicated

[kchrist]

While I agree wholeheartedly that pharmacists do not have the authority nor the right to refuse to fill valid prescriptions, that doesn't change the fact that it's a well-documented problem. One pharmacy in Virginia even advertises the fact.

Re:Like to see this replicated

[rrohbeck]

With the severely limited number of people with known immunity to HIV, and the pain of removing bone marrow, I'm wondering if more than a mere handful of people can be treated via this method.

It says in TFA there is a 30% mortality for bone marrow transplants, so it will never be the therapy of choice. This case is just one more piece of data indicating that the CCR5 receptor is *the* Achilles heel that makes us vulnerable to HIV, so disabling it may be the cure.

Re:Like to see this replicated

[Metasquares]

From Wikipedia:

Individuals with the Delta 32 allele of CCR5 are healthy, suggesting that CCR5 is largely dispensable. However, CCR5 apparently plays a role in mediating resistance to West Nile virus infection in humans, as CCR5-Delta 32 individuals have shown to be disproportionately at higher risk of West Nile virus in studies,[5] indicating that not all of the functions of CCR5 may be compensated by other receptors.

Preventing this receptor from functioning does not appear to disable the immune system, though it may raise the risk of contracting certain specific diseases. This is probably an acceptable tradeoff for the limited period of time a patient with HIV would be required to take such a drug. If you're going to be a jerk, at least make sure you get your information right before you flame.

Re:Like to see this replicated

[Anonymous Coward]

Just because Hitler did something doesn't make it bad. I'm sure Hitler ate and drank, but does that make you a nazi when you have breakfast?

Only if I'm having Luftwaffles!

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

[PCM2]

Well the GP of this post is not completely off. What they may be referring to is the fact that one prominent researcher's study came to the conclusion that HIV was not highly correlated to AIDS which suggested that HIV was not the causing the AIDS. Immediately he was kicked out of the scientific community as they stated that he should be jailed for life for trying to disprove a current hypothesis (which is the point of being scientific).

Part of your claim is mostly true. A prominent researcher (Peter Duesberg) did assert that HIV was not the cause of AIDS. His claims were not based on correlation between AIDS and HIV, however, because all prominent studies show an extremely high correlation -- people with AIDS invariably have HIV. Duesberg's argument was that correlation did not equal causation.

The second part of your claim is inflammatory and inaccurate. It is possible that some individuals expressed the sentiment that Duesberg should be jailed; this would be their own personal opinions. But Duesberg was not "drummed out of the scientific community" by any means. To this day he remains a professor of biochemistry and molecular biology at UC Berkeley.

Re:Like to see this replicated

[redcaboodle]

They can't be vectors because the viruses have no chance to multiply in their bodies and die fast.

Same thing as with other viral diseases like measles, flu oder German measles. If you get the inoculation ratio high enough you have herd immunity. It's how smallpox was eradicated. Measles are supposed to go next. Flu has too many varieties for this to work but I hear a new vaccine is under development that works with all strains.

Re:Like to see this replicated

[teklob]

I'm only an undergrad heading towards immunology, but from what I can tell from that paper you posted, the idea is not so much to stimulate an immune response in the patient, per se.

The immune 'response' is generated in another animal, in this case antibodies in a rabbit, to a protein resembling CCR5 receptor. This antibody is only injected back into the patient after numerous purification steps, to ensure as little cross reactivity as possible. The idea is that an antibody will bind very tightly to the exact molecule it's raised against, thereby blocking the entry of HIV. Any response to this new 'drug' antibody by the normal immune mechanisms is both unnecessary and unwanted.

The study looks promising but since they don't know exactly what CCR5 actually looks like, they are still trying to find out what the best blocker will be. Again I have very little experience with these matters, but once this is discovered I don't see why a monoclonal antibody could be grown that would be extremely specific and likely eliminate cross reactivity.

Any immunologists please feel free to correct me if I'm wrong.

Re:Like to see this replicated

[Mutatis Mutandis]

Excellent post, but I would just like to add a few more caveats. As you probably know, but most people certainly don't, HIV occurs in a wide range of variant strains, which use either CD4 and CXCR4 or CD4 and CCR5. This is a property called "tropism" and HIV strains are classified as X4 or R5 tropic.

But actually, from the data I have seen, few viruses exhibit a really pure tropism. There are a lot of dual-tropic X4R5 virus strains that have some flexibility to use CXCR4 or CCR5 as the opportunity offers itself; this is not surprising, as one variant must be capable of evolving into the other. Also, all patients carry diverse virus populations, because HIV is so sloppy in replicating itself, and a patient may well have 99.9% of R5-tropic viruses and 0.1% of X4-tropic viruses. (0.1% is about the limit of what can be detected with current, and very expensive, methods.)

This is cause for concern. A treatment that blocks the replication of R5-tropic viruses may well favour the replication of X4 strains. There already are indications that this happens in some patients on maraviroc treatment. Driving a virus population to become entirely X4 tropic would probably not be advisable, as there is reason to believe that these strains do more damage. The X4-tropic HIV strains are generally associated with the late stages of infection and the development of AIDS.

Therefore I doubt that anyone is going to advocated bone marrow transplants as a way to treat HIV. The risk is just too big, because this form of treatment is (almost) irreversible. Treatment with maravoric should always be preceded by tropism testing, and can be stopped if it doesn't work.

Finally, 2 years of undetectable viral load in absence of ARV treatment is an impressive result, but IMHO it is still too early to call the patient cured. He may well still have proviral DNA in his cells.

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

[AmonTheMetalhead]

Why do you people tolerate laws like that?!

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

[lysergic.acid]

i think one of the "protections" given to pharmacists by the conscience clause is that employees cannot be fired or otherwise punished for refusing to fill a prescription based on religious grounds. from Wikipedia:

Conscience clauses are clauses in laws in some parts of the United States which permit pharmacists, physicians, and other providers of health care not to provide certain medical services for reasons of religion or conscience. Those who choose not to provide services may not be disciplined or discriminated against.
[...]
Corporate Policy

Some pharmacies in U.S. jurisdictions with conscience clauses, including CVS and Target, allow pharmacists to choose, without penalty, not to dispense birth control pills. Target requires the objecting pharmacist to recommend another Target location that will dispense the medication.

Re:Like to see this replicated

[Miseph]

It is very widely believed that the VERY slow response to the HIV/AIDS epidemic was inspired by the widespread belief that it is simply punishment for the sins of promiscuity, homosexuality and drug abuse. I don't know where you've been, but that's hardly an accusation from far left field.

There are also confirmed cases of nations refusing to take any action, or permit any treatment for HIV/AIDS on precisely those grounds. Not first world industrials, mind you, but even third world African dirt farms doing it is abhorrent.

Re:Like to see this replicated

[ShakaUVM]

>>Black Death is not a virus. It is a bacterium. Yersinia pestis.

Maybe.

Yersina is actually just our best guess, but the modern version of it doesn't match symptoms of the black death from back in the day, so it could be something else entirely.

Re:Like to see this replicated

[PCM2]

Words fail me. The DEFINITION of AIDS REQUIRES the patient to be 'HIV positive' in order for them to be diagnosed with 'AIDS'... i.e. it's a circular argument, moron...

Well, that's Koch's Postulates for you. If an organism has a disease and you can isolate a pathogen from that organism and then culture that pathogen outside the organism, then introduce that pathogen to another organism and the new organism exhibits the same disease... well, if you can do that, then Koch might say you're onto something. (This HAS been done with HIV/AIDS, by the way.)

By your logic, if the definition of having the flu requires that the patient be infected with a strain of the influenza virus, then it's a circular argument to claim that influenza causes the flu. So long as influenza can be isolated from any organism that doesn't have sniffles, then influenza must not cause flu.

Or to put it even more simply for you retards: TB death - HIV = TB death TB death WITH HIV = 'AIDS'

It is you who are making the circular argument. It is entirely possible to die of tuberculosis without having a compromised immune system -- in fact, it happens all the time -- and these deaths would not be classified as AIDS. A tuberculosis patient who does not mount an immune response is an anomaly, and then doctors must investigate why there is no immune response. Tuberculosis is not caused by a virus, and does not attack immune system cells, therefore a low T-cell count is not considered a symptom of tuberculosis. HIV is a virus and HIV has been shown to attack immune cells, therefore when a patient with both tuberculosis and HIV dies of tuberculosis after having failed to mount an immune response, it seems only logical to suspect HIV. But you argue that HIV does not cause AIDS, and in fact HIV is a harmless virus, and therefore someone who dies of TB with a compromised immune system who also has HIV could not have failed to mount an immune response because of HIV. What, then is the reason for the lack of immune response?

All the scientific evidence proves, beyond ANY doubt, that 'AIDS' is not a sexually transmitted disease, that 'AIDS' 'medications' are what kill people in the West

How? How does it prove this? Please explain, because so far it doesn't seem as if you're adequately informed.

The article you cite is extremely easy to rebut. Like Duseberg's original claims, it does not cite any research later than 1997. HIV/AIDS research has come a long, long way since then. Furthermore, the article only focuses on research into AIDS cases in the U.S. Its hypothesis is that AIDS is caused by the use of AZT and other drugs, including recreational drugs. It furthermore claims that almost all AIDS is found in homosexual men and heterosexual drug abusers. The implication is that behaviors, including sex between men and drug use, are the cause of AIDS.

How does this article explain the AIDS epidemic in Africa, where AIDS is far, far more prevalent than in the U.S.? During the height of the African epidemic, Africans did not have access to AZT or similar drugs, nor did they use cocaine and amyl poppers in any great prevalence. Furthermore, in Africa the AIDS epidemic is primarily a disease of heterosexuals, including females.

How does a behavior-based cause of AIDS explain cases of AIDS in children and hemophiliacs?

How does this theory of AIDS explain why HIV+ patients have had longer lifespans since the beginning of the HAART (highly active antiretroviral therapy) era? If, as you claim, the cause of AIDS is in fact the drugs designed to cure it, then why does giving patients a combination of many such drugs make them live longer than they did when they had just one such drug (AZT)?

Of course, none of you will bother reading it, because you might have to THINK, and you would literally rather DIE, wouldn't you?

I have read it. It is you who are not thinking. In f

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

[DebateG]

A variation in the CCR5 gene, called CCR5 delta32, confers immunity if you have two copies of the gene (remember, you get one copy from each of your parents). It's been known for a while that this is associated with AIDS resistance, so there have been many large cross-sectional studies to look at the population frequency. Although it is possible that the gene is more widespread in certain populations, it's still rare (10% in white of European descent, 2% in Asians); remember you must have *both* copies of the gene to be resistant to AIDS only ~1% of Europeans have that. The only way you'd know is to have the test for that specific mutation, and as far as I know, it's not really widely used clinically. Like I said, the main problem is that the bone marrow registries are quite small, and you can't find suitable matches for people based on their MHC matching. The chance of finding one of those isn't particularly good. You have to multiple that times the probability of having the right CCR5 type and we're talking pretty rare.

Re:Like to see this replicated

[Foobar of Borg]

So, unless that person offers you a bone-marrow transplant, it's probably still a good idea to use a rubber...

Great! So now it's gone from "Will you respect me in the morning?" to "Will you give me a bone marrow transplant in the morning?" I swear! Some women are never satisfied.

Re:Like to see this replicated

[Lost Engineer]

I propose we dedicate 100% of GDP to extending the lives of the old and the sick. Now my conscience is clear.

Re:Like to see this replicated

[ceoyoyo]

No. Bone marrow stem cells are very difficult to keep in culture, never mind amplify to a great degree. There's some promising research, but bone marrow transplants are generally pretty straight shots from donor to recipient.

Re:Like to see this replicated

[BiggerIsBetter]

I dunno ... is she really hot?

Nobody said it would be a she.

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

[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.

Re:Like to see this replicated

[mcgrew]

I met a really nice woman in my favorite bar, and we really hit it off. I asked her out to dinner, we have a date for Friday.

I found out a day or two ago that this woman has AIDS. Is there a test to see if you're immune to this disease? Because if not the date Friday will be as far as it goes; I can't be more than "just friends" with a woman with AIDS unless I find out I'm immune.

AFAIK all my anscestors were European.

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.

Re:So you need immune bone marrow?

[v1]

Bone marrow replicates itself. You can keep digging it out of the same person's bone, or out of someone who receives it.

Though I've heard this procedure is quite painful, breaking into bones to dig out (or stuff in) marrow.

Re:So you need immune bone marrow?

[Tubal-Cain]

Any hope of putting the marrow into a petri dish and growing more?

Re:So you need immune bone marrow?

[jimicus]

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?

It's not quite as simple as that. As I understand it, there are different bone marrow types - just like you get different blood types - and for a transplant to be successful, you want to be transferring to someone with the same type. So for every HIV+ patient, you need to find a donor who is not only of the right type, but is also naturally immune.

Re:So you need immune bone marrow?

[DebateG]

Well, there are two problems with this. Firstly, hematopoietic stem cells don't last very long in culture. Lots of people are trying to figure out why, but I'm not optimistic that this problem will be solved any time soon since the cells normally exist in a complex microenvironment in the marrow that we don't really understand yet. But more importantly is the issue of MHC typing. While you need someone who has the CCR5 mutation (which is pretty rare), you also need to have someone who matches your MHC type. Think of MHC as the molecules that allow your body to identify self from non-self. The more MHC matches you have with the donor, the less chance you have of developing a life-threatening disorder called graft vs. host disease. Ideally, doctors want someone related to you, but if those people don't match, you have to do an unrelated donor search. Generally, finding a MHC match requires a large registry search that takes weeks to months to carry out, and many people, especially non-whites (due to the lack of representation of those elasticities in the bank), do not have a match.

found the missing second to last step!

[Anonymous Coward]

1) Be born with natural HIV immunity.
2) Sell bone marrow to desperate people.
3) Profit!

Peer review

[FeatureBug]

The Wall Street Journal is a fine newspaper, but it is not a scientifically peer-reviewed journal. I'd wait and see what the peer review process decides about this proposed treatment. It would not be the first time that a "revolutionary" treatment has failed to prove itself in peer review.

Re:Is it for real this time?

[maugle]

Sure, it's real. You just have to find someone who's immune to HIV, and then take his bone marrow. Easy!

Re:Is it for real this time?

[mapkinase]

I am not aware of anything that would require a condom for its movement.

Re:Is it for real this time?

[ScrewMaster]

Over the years, I've witnessed probably 640 articles on a cure for HIV either having been discovered, or very near.

Well, 640 articles should be enough for anyone.

Yeah great and all

[NotSoHeavyD3]

I mean other than the downsides of a bone marrow transplant actually being one of the riskiest procedures around, often killing anything up to 20% of recipients within a couple of weeks. Maybe after all drug treatment options have failed this might be a good idea.

Re:Yeah great and all

[compro01]

I'm pretty sure that mortality rate is due to the fact that they are already in bad shape (advanced leukemia, auto-immune, etc.) prior to the transplant, in addition to the fact that you need to wipe out their immune system (via radiation or some other method) prior to the transplant which results in them having no immune system until the donor marrow takes hold, which means that pretty much any kind of infection will kill them and creating and maintaining a completely sterile environment for that length of time is difficult. AFAICT, the wiping out is not needed in this case, as the virus is already suppressing the immune system, allowing a more graceful transition to the new marrow.

Re:Germans

[Atheose]

Yeah, after reading the article from the original post I did a bit of research on it myself--apparently 1% of all Europeans have this CCR5 mutation? The bad news: about 30% of people who get bone marrow transplants don't survive the procedure, and the CCR5 mutation makes it more likely for them to die of other things lik West Nile Virus.

In any case, this is wonderful news for the scientific community. Even if this doesn't amount to anything it's still a breakthrough that could help piece together the overall picture. Exciting news.

Re:What I'd like to know is...

[dogberto]

Yeah there is...

Currently, the theory is that HIV immunity is provided by a mutation of the CCR5 receptor. In particular, it seems to provide an immunity also to the bubonic plague--it is as a result of the bubonic plague that this recessive mutation has manifested itself today in somewhat greater numbers in certain populations--natural selection, so to speak at work.

check out:
http://www.wired.com/medtech/health/news/2005/01/66198
http://en.wikipedia.org/wiki/CCR5

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:What I'd like to know is...

[NotSoHeavyD3]

Bone marrow is full of stem cells which is kind of the point which is why the technical term is Hematopoietic stem cell transplantation http://en.wikipedia.org/wiki/Bone_marrow_transplant

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...

Insurance companies won't buy into this

[bjdevil66]

Good luck getting coverage for that kind of treatment. Probable responses: "The vat of pills you take every day is much cheaper. Claim denied." Or, "Experimental - denied."

If this truly works on a large scale, this particular treatment will unfortunately be for the upper class only.

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).

natural immunity problem

[girlintraining]

Most of what I've read about so-called natural immunity isn't really immunity per-se. People with immunity still carry the HIV virus; It just doesn't turn into AIDS for a long time, but in a lot of cases, eventually it overcomes the immunity. Here's an article on one such study [BBC].

Re:natural immunity problem

[cleojo42]

What you are thinking about is called long-term non-progressers. If the virus can't actually get into the cell, which is what we are talking about here, means that while there might be some HIV in the blood (floating around in the liquid part), it can't actually infect any of the cells. No infection, no disease.

Re:I know what bone marrow transplants do to peopl

[jcr]

BMT is a major, major procedure.

With about 30% mortality, I've read.

-jcr

Re:Nerds everywhere rejoice

[ScrewMaster]

The return of free sex is near!

Yeah, right. When did nerds ever partake of free sex? Not that they didn't want to, but you know ... they were nerds.

Survival rates

[Harmonious Botch]

The bad news: about 30% of people who get bone marrow transplants don't survive the procedure,

But the people who currently get bone marrow transplants are already in very bad shape to survive surgery - far worse than a person who has aids. Most bone marrow transplants are done to cure leukemia or some similar disease that damages blood cells. These blood cells includes platelets which are necessary for coagulating blood. If your blood does not coagulate well, you don't have a good chance of surviving surgery.

So the very disease that makes bone marrow transplants necessary often prevents the patient from surviving the surgery to cure it. With AIDS patients, this would not be a problem, so one could expect a better survival rate.

Re:Evolution.

[ScrewMaster]

The dude who is immune is clearly a case of evolution. Survival of the fittest.

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. Granted, this process would be fatal to the majority of the infected but the survivors would be graced with an extended lifespan, as well as physical and intellectual powers far beyond those of mortal men.

Yeah okay. Good plot for a Sci-Fi Channel Made-for-TV movie, or maybe a Direct-to-DVD production.

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:Evolution as a problem solver

[st0rmshad0w]

Actually, the natural immunity can largely be traced back to small populations in europe that had very large survival rates during the Black Death in the middle ages. The immunity was likely present prior to HIV's emergence.

Carrier?

[wonkavader]

Does this or does this not still leave the recipient as an HIV carrier?

Re:Use Resources Wisely

[turgid]

I hope these operations for people who got AIDS by accident. No one who earned AIDS by promiscuous sexual behavior deserves to get these limited resources.

Don't worry. I'm sure God will come up with something even more dastardly to punish them. Maybe it will even involve EDS.

Re:What I'd like to know is...

[Sethb]

23AndMe includes HIV Resistance in their battery of genetic tests.

Erm, this is Slashdot

[Malevolent Tester]

What relevance do sexually transmitted diseases have here?

Re:I know what bone marrow transplants do to peopl

[ScrewMaster]

But I just don't know if this is the best way to deal with it once someone is infected.

I'd say it isn't, given the nature of a bone marrow transplant (such things always seems so easy on TV.) Still, there may be other ways to transfer this genetic protection to an individual (a retrovirus maybe) so this qualifies as significant progress.

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:Monetization

[SlashBugs]

Making money off of a disease which is very much kept in the vague, unclear, opaque situation is evil.
Where is the reproducible proof that HIV exists?
Where is the reproducible proof that HIV causes AIDS?

Go to the (American-run but internationally funded and popular) National Centre for Biotechnology Information here: http://www.ncbi.nlm.nih.gov/sites/entrez ...and type "HIV" into the search box. You'll get just under 192,000 peer-reviewd articles from groups all over the world, funded by various governments, public and private companies, charities and rich donors. Anything from HIV genome sequences and molecular sctructures through molecular biology, disease progression, transmission studies, all the way to local- regional- and global epidemiological studies. The evidence is pretty damn strong and well understood from the atomic level up to the global level.

Altenatively, click on the "Reviews" tab and it'll give you a mere 24,000 articles assessing, collating and criticising the others. Have fun!

True for HIV, True for HPV.
True for whatever.

When you've finsihsed the HIV evidence, feel free to look up the 15,000 HPV articles (or just 12,600 if you restrict your seach to "HPV AND cancer"). The HPV thing is actually very easy: most viruses carry genes evolved to push cells into their growth phase, because that forces the cells to release and synthesise resources that the virus must hijack to replicate. HPV-associated cancer happens when the viral gene gets incorporated into the cell's DNA (rare, but through well-established mechanisms) and get permanently switched on, making the cell grow and divide constantly. Any biology undergrad could tell you that if you asked. It's more common in the cervix simply because it's out of sight, and doesn't get noticed until it's really big and nasty. (Which is why all sexually actve women should be screened: catch it within the first 5 years and the cure rate is better than 98%. It's an easy cure if you *find* it)

THINK first. Do your research.

My undergraduate degree is in virology and I've just finished a PhD looking at how viruses interact with cancer and parts of the immune system. I've done plenty of thinking, and a hell of a lot o research. Now it's time for *you* to think, and for *you* to do some fucking research.

You're no better than the creatioists who say that evolution's impossible but have never botheres to get a fcuking clue how it actually works.

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:Is it for real this time?

[TheLink]

I'm sure you'll find other incurable sexually transmitted diseases. For example: Hepatitis B and C.

So I recommend you:
a) use condoms
b) don't be promiscuous and pick a partner who isn't promiscuous
c) be abstinent

c) should be easy for most slashdotters :).

Re:Evolution.

[bitrex]

Yeah okay. Good plot for a Sci-Fi Channel Made-for-TV movie, or maybe a Direct-to-DVD production.

Or a Greg Bear novel. I can't wait for my kids to smell more than kids already do!

You know one kind of method for one kind of illnes

[Marrow]

I have had a bone marrow transplant. No radiation, minimal chemo-like drugs. In the hospital a week or a week and a half, 6 months of outpatient monitoring and I was cured.

For the AIDS treatment to work, they would most likely use something closer to my transplant protocol than the full oblation that they use with cancer patients.

Note to those interested: They dont have to go in with needles or drills to "dig out" the bone marrow from the donor. They give you a drug call the "G" that causes your bone marrow to percolate into your bloodstream. Then they filter it out with a dialysis-type procedure. Its fairly painless. I had it done to save my own marrow in case something went wrong with the transplant.

Re:Interesting solution for more bone marrow

[ScrewMaster]

I like it, a GPL-like solution. "By accepting this bone marrow in your body you agree to provide your own copy of bone marrow at least twice on same conditions you have received it."

Hm, sounds sort of ... viral in nature, doesn't it?

Quick answer

[PCM2]

STD cases are rising every year (NON-CUMULATIVE figures, of course), yet where are all the teenagers dying from 'AIDS'?

The fast answer is that HIV is not a highly contagious disease. In fact, compared to something like measles -- or HPV or active herpes -- it is actually quite difficult to catch HIV. The reason we focus so much attention on it, however, is because unlike herpes or genital warts, you die from it.

That is, until recently. Compared to 1981, we have quite a lot of experience treating AIDS. In fact, the clinical definition of AIDS an HIV-positive patient with fewer than 200 T-cells per cubic millimeter of blood. By definition, if we can stop your T-cells from dying, you don't get AIDS. (But if we stop treating you, you do.)

Other than that, it's 2008. To say that HIV does not cause AIDS at this late stage in the game is akin to denying evolution. The amount of scientific evidence linking HIV to AIDS is simply overwhelming.

I'm not at the tail end of a PhD in biology or anything close, but even I know this much. You do yourself a disservice by approaching scientific topics with blinkers on.

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[account_deleted]

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neat but is it really a "cure?"

[seeker_1us]

Will the newly "immune" people be carriers of HIV?

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Re:Monetization

[MLease]

People have a tendency to make typos when they are upset. The parent poster was understandably upset about the ignorance on display in the grandparent post.

-Mike

Re:You know one kind of method for one kind of ill

[SlashBugs]

The drug is Granulocyte Macrophage Colony Stimulating Factor (GM-CSF) if anyone wants to look it up. It's just a growth hormone that you have produced in your body naturally. They just give you a *lot* of it, causing your stem cells to start dividing. Some stay in your bone marrow, the excess cells move out into the bloodstream, from which they can be painlessly extracted.

I know someone who's had cells extracted that way, and she described it like Marrow (very apt name!) does. The hormone treatment made her feel like she had a cold coming for about a week, and the extraction procedure (required about 2 hours sitting in a comfy chair) was just "really boring".

If you sign up to be a bone marrow donor (you should if you can! Brits check out the Anthony Nolan Trust), that's what you're signing up to do: feel like you have a mild cold, be bored for two hours and hopefully save someone's life.

Very rarely (more common in people 50+) the drug doesn't work well and they do ask if they ca take your cells directly from the bone. I know a woman who had this done too. She stayed in hospital for 2 days after, rested in bed for another 2 days and was back in work after a week. It wasn't great fun, but it healed up perfectly and painlessly after a few weeks. She said it was definately worth it to try saving someone's life.

Re:National conscience clause

[MazzThePianoman]

There is a national version of a "conscience clause" in the works and it allows anybody involved with medical care, from ambulance drivers to doctors, to deny service based on their own personal beliefs. The 2008 bill expands this provision to include "care" as an activity that an organization may refuse to provide based on a moral or religious objection. This will allow organizations who receive U.S. funds to deny services to those whose behavior, identity, religion, or other attributes may be deemed objectionable. Scary stuff

How about patients that refuse to be treated?

[Zerelli]

I see a lot of talk about people who are refused treatment and such, but I have seen no mention of the people who refuse to get treated or to stop spreading the disease. My wife worked as a case management RN and set up an AIDS/HIV clinic intended to supply free treatment to those who could not afford it. The issue they had was that a lot of these people do not want to be bothered by treatment. They seem to either not give a shit because their lives are already hell or they assume that because they have it they are going to die so they do not want to be bothered. To me the biggest problem with HIV/AIDS are the people who still go out there sharing needles and engaging in unsafe sex. I think that needs to be prosecuted a lot more vigorously. I have seen spouses who were dying because their significant other was going out on the DL and brought home a nice case of HIV/AIDS (I used to be a MLT/phlebot). The guy that did that should be prosecuted for murder.