'Boston Patients' Still HIV Free After Quitting Antiretroviral Meds

ananyo writes "Two men with HIV may have been cured after they received stem-cell transplants to treat the blood cancer lymphoma, their doctors announced today at the International AIDS Society Conference in Kuala Lumpur. One of the men received stem-cell transplants to replace his blood-cell-producing bone marrow about three years ago, and the other five years ago. Their regimens were similar to one used on Timothy Ray Brown, the 'Berlin patient' who has been living HIV-free for six years and is the only adult to have been declared cured of HIV. Last July, doctors announced that the two men — the 'Boston patients' — appeared to be living without detectable levels of HIV in their blood, but they were still taking antiretroviral medications at that time." The story reports that they have only been off of medication for seven and fifteen weeks and they won't know for a year, but signs are looking positive.

Comments

Summary misses a small detail.

[SuricouRaven]

There's a good chance this 'cure' will kill the patent. It works, but it's dangerous. The choice is between a treatment that may kill you now, or a disease that will kill you eventually. And either way you'll get to take lots and lots of drugs with nasty side effects.

Re:Summary misses a small detail.

[MozeeToby]

Marrow transplants are dangerous, and there's no obvious way to go about making them safer. The problems are a fundamental result of the procedure itself, not simply a side effect. First, you must kill off the patient's bone marrow, there's simply no way around it since the bone marrow is what is causing the problem you are trying to treat. The only ways we know how to do that are with near fatal doses of chemotherapy or radiation. Actually, the doses are fatal, if they do what they are supposed to do and the patient doesn't receive their transplant they will die (when you donate there is a time period after the patient has had their marrow destroyed but before you actually donate, if you change your mind and decide not to donate during that time period the patient will almost certainly die unless another donor can be found and medically cleared in a matter of days). Then there's a period of not days, but weeks where the patient has no functioning immune system to speak of, not to mention severely limited red blood cell production. Then there's graft vs host disease where the immune system rejects it's new host body, essentially like organ rejection except in this case it affects the entire body. Then there's liver and kidney damage (both from the chemo and/or radiation and as a result of the transplant itself) and increased risk of cancer (not related to the original cancer being treated).

And that's all assuming that a suitable match can be found, which isn't guaranteed. A non-ideal donor increases the risk of complications, especially graft vs host (but can actually reduce the risk of cancer relapse interestingly). Part of the reason a donor can't always be found is that there simply aren't enough people on the registry, largely because people have this notion that donation is an extremely painful process. This was true in the past, but most donors now donate peripheral stem cells, where a drug (filgrastim) is given for a few days and donation is done through vein in the arm.

Re:Stem cells

[Petron]

Appears to come from modifying adult blood-forming stem cells. Adult stem cells have little to no controversy.

Re:There's finally more money in the cure....

[the gnat]

A patient of chemo for cancer will take many thousands of dollars each year to combat their disease, so this is where cancer treatment seems to have stalled out in the US.

Or maybe it's because treating cancer is insanely fucking difficult, because it isn't actually one disease but hundreds or thousands of different cellular regulation disorders which simply happen to have broadly similar effects, because really weeding out every last tumor cell would require therapies so drastic that they'd be likely to kill the patient, and because many cancers tend to evolve drug resistance over time. The costs of cancer go way beyond prescriptions for a few name-brand drugs (which aren't even available for everything); they include older therapies, hospitalization, and surgery. Insurance companies would save multiple hundreds of thousands of dollars per patient if there was a magic drug that cured cancer, and would happily pay a large amount for such a drug, so it's not like there's no profit to be had.