Scientists Report a Second Person Has Been Cured of HIV (reuters.com)

Scientists have reported that an HIV-positive man in Britain has been cleared of the AIDS virus after he received a bone marrow transplant from an HIV resistant donor. This is the second known adult worldwide to be cleared of HIV; the first was an American man, Timothy Brown, who became known as the Berlin patient when he underwent similar treatment in Germany more than a decade ago. According to HIV experts, Brown is still HIV-free. Reuters reports: Almost three years after receiving bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection - and more than 18 months after coming off antiretroviral drugs - highly sensitive tests still show no trace of the man's previous HIV infection. The case is a proof of the concept that scientists will one day be able to end AIDS, the doctors said, but does not mean a cure for HIV has been found. The man is being called "the London patient," in part because his case is similar to the first known case of a functional cure of HIV.

"There is no virus there that we can measure. We can't detect anything," said Ravindra Gupta, a professor and HIV biologist who co-led a team of doctors treating the man. Gupta described his patient as "functionally cured" and "in remission," but cautioned: "It's too early to say he's cured." Gupta, now at Cambridge University, treated the London patient when he was working at University College London. The man had contracted HIV in 2003, Gupta said, and in 2012 was also diagnosed with a type of blood cancer called Hodgkin's Lymphoma. In 2016, when he was very sick with cancer, doctors decided to seek a transplant match for him. "This was really his last chance of survival," Gupta told Reuters in an interview. The donor -- who was unrelated -- had a genetic mutation known as "CCR5 delta 32," which confers resistance to HIV. The transplant went relatively smoothly, Gupta said, but there were some side effects, including the patient suffering a period of "graft-versus-host" disease - a condition in which donor immune cells attack the recipient's immune cells.

Comments

Gupta cautioned: It's too early to say he's cured

[Anonymous Coward]

Slashdot headline: Second person has been cured of HIV.

I have this mutation

[Anonymous Coward]

According to genotyping results, I have the HIV resistance mutation that makes this cure possible.

Re:I have this mutation

[Anonymous Coward]

How much for a pint of your marrow?

Re:I have this mutation

[AmiMoJo]

Unfortunately bone marrow transplant isn't a very viable treatment, because the mortality rate is fairly high and in general it's probably better to just take the existing treatments for HIV. But it provides a hint as to how a future cure may be developed.

Some kind of gene therapy may be feasible once the exact mechanism by which this worked is fully understood.

Re: I have this mutation

[Anonymous Coward]

A complex cure. It may as well be nonsense to most readers. Well, unless they are able to read the word bone marrow and not think space aliens

Re: I have this mutation

[Anonymous Coward]

You should test this by working at a San Francisco glory hole for a couple of months.

Re:I have this mutation

[Oswald McWeany]

According to genotyping results, I have the HIV resistance mutation that makes this cure possible.

Quick lads- let's get him and harvest his marrow!

Re:I have this mutation

[Anonymous Coward]

I'm well aware, I'm an inmunologist.
But come on, eh, I'll give you a good price! Beating leukemia and HIV all in one swell package!

Re: I have this mutation

[Anonymous Coward]

Glory holes are oral. The virus spreads by ejaculation into the anus.

"Sloppy, I think I missed the hole" - DEVO.

Re:I have this mutation

[Ol Olsoc]

According to genotyping results, I have the HIV resistance mutation that makes this cure possible.

Quick lads- let's get him and harvest his marrow!

Then again, his social options have just expanded! I really am going to go to hell........

Re: I have this mutation

[Anonymous Coward]

It's theoretically possible to catch the HIV orally but very unlikely. As to how unlikely, to my knowledge, there have been no reported cases of transmission this way. Keep in mind, people engaging in risky behaviors like unprotected sex with someone who isn't (truly) monogamous and or tested regularly are fairly likely to engage in oral as a standard subset of their normal activities.

The mouth and stomach are very hostile environments for HIV but an open wound in the mouth or throat could certainly lead to an infection under the right conditions. If you have an open wound in your mouth you really shouldn't be engaging in any sort of oral sex anyways for a lot of reasons.

Re: I have this mutation

[Anonymous Coward]

Anyone who says they don't is lying. I uses to date a Catholic girl who was a total butt slut.

Re:I have this mutation

[Anonymous Coward]

> Quick lads- let's get him and harvest his marrow!

No need to do anything that drastic. There's actually a drug developed ~15 years ago that mimics the effect of a CCR5-delta32 mutation (by competitively binding to the protein on T-cells... in effect, depriving the HIV of a parking spot so it can't get in the front door.

It's called "Maraviroc"

It's not a commonly used drug for either treatment or prevention. For prevention (google: "PrEP" or "Pre-Exposure Prophylaxis"), it's not quite as effective as Truvada, and for treatment, it's generally not as effective as Truvada + an integrase inhibitor. It also has more side effects, including the main side effect caused by having a CCR5-delta32 mutation: greater susceptibility to respiratory infections. See, a CCR5-delta32 mutation isn't quite a "get out of jail free" card. It's kind of like sickle-cell anemia. One copy of the sickle cell gene gives partial immunity to malaria. Two copies leaves you with a chronic lifelong medical problem. One copy of CCR5-delta32 enables you to live with an untreated HIV infection for years before it progresses to AIDS. Two copies provides immunity to most strains of HIV, but leaves you vulnerable to getting sick from every respiratory infection you come in contact with.

At the time it was developed, everyone thought Maraviroc was going to be a blockbuster drug. It ended up kind of fizzling out, just because other drugs ended up working better with fewer side effects. It's not terribly useful as a "rescue" drug for patients who've developed resistance to other meds (by failing to take them consistently), because the patients with the worst resistance to mainstream HIV meds tend to be the ones who've ALSO progressed to CCR5-mutated HIV (in which case, Maraviroc won't hurt... but won't really do much good, either). And for prevention, if I had a choice between two drugs that were roughly equal in effectiveness (Truvada vs Maraviroc), but one (Maraviroc) left me vulnerable to constantly having colds, influenza, sinus infections, pneumonia, and adenovirus infections... well, I'd pick Truvada, hands-down, no contest.

Re:I have this mutation

[ceoyoyo]

The big reason bone marrow transplants are dangerous is because you have to give the patient what is effectively a lethal dose of chemo or radiation to kill off their existing immune system. I expect the next few years will bring a cure for HIV infection that involves selectively killing off T cells with antibody therapy, then reconstituting the immune system with autologous stem cells engineered to be HIV resistant.

Immune targeted antibody therapies are already approved for multiple sclerosis and a few other autoimmune diseases. It won't be long before somebody tries it on HIV.

Re:I have this mutation

[drwho]

Me too. Are you heterozygous or homozygous ( yeah be prepared for beavis and butthead jokes ) ? I met someone doing genetic research on HIV and mentioned this, and he was fascinated, because I was the only person he had met who knowingly had this mutation. It still doesn't get me to the head of the line in getting $$ for marrow transplants though. There is not organized system for handling this. Yes, I would want money for my pain and suffering. Call me selfish if you want but people with other mutations get money for it all the time, just not in this way.

HIV != AIDS

[crvtec]

The article gets it wrong too, but HIV is not the same as AIDS. Both patients were 'cured' of HIV (not AIDS). https://www.webmd.com/hiv-aids...

Re:HIV != AIDS

[Anonymous Coward]

Poor guy, what a sad experience. He must have had troubles in his sexual relations afterward, who wouldn't?

Re:HIV != AIDS

[jonnythan]

Neither the summary nor article says anyone was cured of AIDS.

It says he "has been cleared of the AIDS virus." HIV is definitely the AIDS virus. The article and summary are accurate.

Re:HIV != AIDS

[Gilgaron]

You don't have AIDS anymore if you've been cleared of HIV...

Re:HIV != AIDS

[thereddaikon]

Your post is akin to saying "He wasn't cured of the common cold. He was cured of rhinovirus." A technically correct but utterly useless distinction for laypeople. AIDS is the disease caused by HIV. While it is possible to have the virus in you without it having progressed to a full outbreak that really only matters in medical terms.

Re: HIV != AIDS

[Anonymous Coward]

That's not how HIV works, which is why it's inaccurate. If you notice the language Gupta uses ("functionally cured"), his is accurate. There's a reason "functional" is typically thrown in as a qualifier for many diseases.

It's often difficult to impossible to say something doesn't exist (proving a negative) versus identifying something does exist (providing a positive). It's the same reason cancer patients often use the terms "remission" vs. cured. "Cured" implies 100% eradication to most people.

With HIV, under recent/current medication alone, it's possible to get active HIV counts/viral loads (or detection of antibody responses) down so low that our current technology cannot detect HIV in blood (and other) samples of an infected individual. This is referred to as sero-conversion (from positive detection to negative or vice versa). This is a limitation of our detection technologies/methodologies and a testament to how well treatment (not curing) has become.

Seroconverting from HIV positive to negative absolutely does *not* mean the individual is "cured" (that would be a false negative), it simply means the virus has been so suppressed its damage is minimal and its replication rate is incredible low. These people can then live normal lives without their longevity really changing much, assuming no resistant mutation of the virus occurs (which happens, in a somewhat similar fashion to antibiotic resistant bacteria) or no new mutations are contracted (there's multiple flavors of HIV so some HIV infected people think it can't get worse and have unprotected sex with other HIV infected, contracting multiple mutations... they don't realize they're making their situation far worse).

Now, what typically happens is if an HIV positive individual who has undetectable levels of HIV (and has had detectable levels of HIV before) stops taking their medications, the virus starts to replicate and spread to the point it is now detectable by our technology again and the persom often will start to exhibit many of the symptoms of having a suppressed immune system. This is typically done under close supervision of a professional immunologist who adjusts dosage and types of medication/therapy.

What makes this Londom patient case incredibly unique (like the Berlin patient) is that after removing the antiretroviral HIV treatments, after a long time (18 months is very long relative to this stuff), the virus is still completely undetectable.

This has only happened one other time with the Berlin patient, so this is potentially incredible (it gives researchers a second set of data points to compare to the Berlin patient and theorize new therapy approaches).

As the article says though, it's too soon to day. After a longer time period if the patient continues to remain sero negative then the confidence will increase that the patient is truly cured. Unless you can comb through the body at a cellular level and show no trace of HIV, it will be nearly impossible to say for sure the person is 100% cured

Re:HIV != AIDS

[Anonymous Coward]

You can't be this stupid.

Re:HIV != AIDS

[Win0ver]

No, the distinction is important, as having HIV does NOT mean you have AIDS. And no one who has AIDS has ever been cured, unlike HIV.

Re:HIV != AIDS

[thereddaikon]

And while it is in medical terms important I think you will find that you are wasting your time. Most people equate HIV and AIDS. There isn't much you can do about it. And making a stink about it on /. where people do understand the difference wont help.

Re:HIV != AIDS

[BringsApples]

Magic Johnson (no pun intended) has been living with HIV since the early 90s.

Re:HIV != AIDS

[Anonymous Coward]

...a bone marrow transplant from an HIV resistant donor...
A resistant donor; then THIS individual should ALSO be resistant, yes?
The proof shouldn't be "we looked and we couldn't find anything"; it SHOULD be "we inoculated him with HIV and the virus didn't survive".

Re:HIV != AIDS

[ceoyoyo]

That's not really true. A cold is a disease, caused by a virus. AIDS is syndrome, not a disease. HIV disables your immune system, then various opportunistic infections all try to be the first to kill you. The latter is AIDS.

Clearing HIV is relatively simple compared to curing all the various infections an AIDS patient might have, never mind fixing all the damage they've done.

Re:HIV != AIDS

[sjames]

If you get rid of the HIV, their immune system will recover and kill the other infections. They may well have lasting effects from their time with AIDS.

Re:HIV != AIDS

[sjames]

If you want to be a stickler, it also means "we injected this non-resistant supject with the same strain and he got AIDS". You first...

Re:HIV != AIDS

[ceoyoyo]

Sadly, that's not usually way it works. Your immune system is much more successful at eliminating (or containing) infections that are not well established.

Re:HIV != AIDS

[Anonymous Coward]

That is not true. Here is an analogy: You have a country with an army to protect it from invaders. There is an outbreak of propaganda that causes officers to print off additional copies, mail them anonymously to random people they know, and then kill themselves. After some time, that propaganda (HIV) will kill off the vast majority of your officers (not having enough officers is akin to AIDS). Now, even if somehow the propaganda is eliminated (cured of HIV) that does not mean that you have enough officers for your army to be effective (you still have AIDS). In fact, your system may be so devastated, there is no guarantee that you'll ever get enough again.

Re:HIV != AIDS

[Kyr Arvin]

You don't have AIDS anymore if you've been cleared of HIV...

AIDS is a condition caused by HIV. HIV kills the immune system, even if it's cleared out, you will still have AIDS if you have no functional immune system. But it might not be contagious.

Re:HIV != AIDS

[Kyr Arvin]

Magic Johnson (no pun intended) has been living with HIV since the early 90s.

Because he's filthy rich, and direct injections of liquified cash cured him.

Re:HIV != AIDS

[Gilgaron]

Kinda, you'll be in a weakened state like you'd be if you'd been through a bought of the measles, but without HIV to kill them off, your lymphocytes will recover in a matter of months.

Re:HIV != AIDS

[thereddaikon]

Ask someone who isn't familiar with medical terms what a syndrome is. At best they will tell you its a fancy word for disease. Again, you are wasting your time on pedantry.

Re:HIV != AIDS

[ceoyoyo]

Slashdot. How far you've fallen.

Puts the early claims into perspective

[gweihir]

Around 1990 we had claims of a "cure in 5...10 years" by actual experts. Now, 30 years later, we actually have an experimental cure that worked two times and both times it was a purely accidental side-effect of a very risky cancer treatment. Hence we still do not have a cure that is worth the risks. Human hubris at work.

Re: Puts the early claims into perspective

[Anonymous Coward]

But were they cured of the urge to sniff stinky hitler toe cheese?

Re:Puts the early claims into perspective

[Anonymous Coward]

The issue here is that there may not be enough economic incentive to search for a cure.

It is much more profitable to give patients lifetime treatments that repress the virus but do not cure the infection completely.

If your company licenses an HIV treatment, there is no financial incentive to invest into research that focuses on finding a cure, as it would be in direct competition with the treatments you are selling already, hence impacting your future profits.

Still, we have gone a long way since the "90's, with patients being able to live (almost) normal lives. The understanding of the HIV virus has also improved considerably since that time.

Re:Puts the early claims into perspective

[gweihir]

Still, we have gone a long way since the "90's, with patients being able to live (almost) normal lives. The understanding of the HIV virus has also improved considerably since that time.

I don't dispute that at all. And this research is hugely valuable for all the things it tells us. I was just commenting about all these "in 5...10 years" prediction and using this one here to make a point.

Re:Puts the early claims into perspective

[Anonymous Coward]

It is much more profitable to give patients lifetime treatments that repress the virus but do not cure the infection completely.

This is where competition comes in. If you come late to that market, you don't have the best antivirus drugs. The very best are probably patented, so you can't even make them. Perhaps licence them, but then you just make money for someone else whose brand is much better known anyway.

So you can't profit form anti-HIV drugs. You can research a cure though. The medical profession as a whole may profit less when you succeed, but you will profit more. You patent this new cure, and make money til the patent runs out. At that time, the virus may be eradicated anyway, leaving little or no profit opportunities for competition.

In the longer run, curing HIV won't really cut into medicine profits. More people survive and get old enough for cancer & heart problems. Fix some of those, and they will get old enough for a rarer type of cancer - and so on. Life always ends in a hospital - so the medical profession will always profit from life.

Re:Puts the early claims into perspective

[Oswald McWeany]

The issue here is that there may not be enough economic incentive to search for a cure.

It is much more profitable to give patients lifetime treatments that repress the virus but do not cure the infection completely.

That may be true from a pharmaceutical-only standpoint- but governments have poured many millions of dollars into HIV research too! Imagine if all major life-threatening diseases got the same treatment as AIDs!

Re:Puts the early claims into perspective

[del_diablo]

Historically(if Wikipedia is to be believed)
HIV started out being studied in USA the 80s because patents where showing signs of both Pneumocystis jirovecii pneumonia(rare) and skin cancer called Kaposi's sarcoma(also rare). Each escalation of the study went from one thing to another, where the abbreviation even changed from GRID(Gay Related Immune Decency) to 4H(homosexuals, heroin users, hemophiliacs, and Haitians.) to AIDS once the cause and effect was studied enough to study the 'healthy population'.

I think hubris is the right word when talking about the topic.
HIV is a RNA virus where the body do not develop immunity after exposure, unlike Influenza. Because the body do not develop immunity, this leads to long term complications, where medication is taken to reduce progress from infected to dying of immune system defects(AIDS).
Because the body do not develop immunity, vaccines has to target the infection vector of HIV (a unique protein). So it targets the infection vector, but not granting immunity to the actual disease(again: Unlike Influenza).
Which leads to the question: How do you treat a disease the body is not curing?
The current answer is "Can't really cure it, prevent escalation and treat it like a chronic disease".

Re:Puts the early claims into perspective

[Gilgaron]

Who would've thought that a rapidly mutating retrovirus which directly attacks the immune system itself would've been so hard to make a vaccine for? It is because of HIV and AIDS research that we have most of the antivirals and antifungals we do today.

Re:Puts the early claims into perspective

[Anonymous Coward]

There’s a ton of misinformation here. Please don’t act like an expert when you don’t know what you’re talking about. The problem with HIV is not that it’s a retrovirus, but that it’s surface proteins mutate frequently and it targets the specific key immune cells that are needed to fight the virus and other infections. The frequent mutations cause the virus to appear to be a whole new virus before the host is able to clear the previous version. Influenza also a retrovirus mutates as well, but slowly enough the immune system can clear it.

Re:Puts the early claims into perspective

[Anonymous Coward]

this from the guy who wants to colonize the universe because someone sent a radio into orbit

Re:Puts the early claims into perspective

[omnichad]

Unless you're the other company that isn't profiting from that treatment.

Re:Puts the early claims into perspective

[Anonymous Coward]

Amen, it's a shame diseases like Type One Diabetes don't get the same research dollars.

A 45 year type one Diabetic.

Re: Puts the early claims into perspective

[Anonymous Coward]

Patents expire and after awhile, cures are open to everyone and a cure is very attractive to reproduce to the general public.

If all businesses do the math and come to the same conclusion that a cure isn't a good business investment in that market then you simply won't have competitors.

Why would a business that deep into research of a treating a disease and providing IP that generates continual revenue streams grow a conscious and pursue a cure? Those best situated to pursue cures are the ones with every financial incentive not to pursue a cure who are driven entirely by financial incentives.

The second a hypothetical competitor did develop a cure, then stop pursing research and look at changing markets when your current parents expire. Pursue other business ventures. Its a no brainer from a business standpoint.

Re: Puts the early claims into perspective

[Anonymous Coward]

The big difference between HIV and most life threatening diseases is that most other harmful diseases aren't communicable and don't spread making their overall potential lower.

Without proper research in HIV, given its nature of being both lethal and sexually transmitted, it was a pretty obvious and scary target to hit. Influenza comes to mind as well being in a similar boat (and more contagious than any STD/STI).

Other big diseases in the US, like heart disease, have also had plenty of research and concluded that most cases that make it such a big target are due to lifestyle choices. While one could argue heart disease is somewhat communicable in a very abstract sense (in the fact it stems from adopting certain widespread cultural aspects like diet), much of the hard science is clear on the largest contributors... the rest needs to be pushed by others at a cultural/educational level. Lung cancer fell in a similar boat in that most (not all) cases were due to smoking. In the US, obesity is another biggie (no pun intended).

Few other diseases come to mind as being as obvious dangerous targets from an overall population perspective (Malaria and TB but those aren't as predominate in the US so they get little attention here). Maybe I think more like an epidemiologist.

To be very clear, I'm not belittling any diseases, simply stating that when looking at humanity as a whole, certain diseases have higher potential for causing more widespread loss of life so for me I understand why they get attention/money for scientific research. Once the science is fairly clear, the rest of the focus is on education (similar to what happened with smoking and lung cancer) and the scientists need to target the next big disease.

I have friends and family with who have had rare diseases and I understand how a given disease could effect ones perspective more than others due to proximity of ones life but we have to remember the bigger picture and why certain targets get chosen first.

Re:Puts the early claims into perspective

[bruce_the_loon]

Whether you can call it hubris or not is debatable. Back in the 90s, the human genome mapping project was just getting going and the understanding of the genetics of HIV was sadly lacking. The researchers said 5 to 10 years because their experience was with vaccines for high speed diseases that overwhelmed the immune system, not something that ran slow and shut down the immune system response.

When they finally dug their collective heads out of the sand and recognized it as a human threat, not a gay or druggie threat, they still didn't understand it properly. So they thought their previous experience would prove similar with HIV. Unrealistic, maybe, naive, definitely, hubris, I don't think so.

Same with cancer cures, the tools we have for fixing the genetic car engine are hammers and chisels, not diagnostic computers and electronic tuning systems. Medicine is still a lot of brute force over ignorance, though we'd rather not admit it.

Re:Puts the early claims into perspective

[del_diablo]

Then why post as AC?
And write one line? It bothers me a lot
Because you don't contribute now, you are just sniding without producing effect or visibility.

Re:Puts the early claims into perspective

[Anonymous Coward]

As a practical matter, "AIDS" IS now "cured", even though "HIV" isn't.

HIV can be successfully beaten back and kept in remission, just like a childhood chicken pox infection that lies dormant & (hopefully) never re-emerges later in life as shingles.

It's also important to distinguish between three broad groups:

* People who are diagnosed within a few months of becoming infected with HIV, begin treatment immediately, and take their meds reliably for life. Aside from having to take the meds, HIV isn't likely to ever really cause any serious problems for them. In fact, this group is statistically a bit MORE likely to enjoy a long life and better health... since they HAVE to go to the doctor at least twice a year for checkups and lab work, they're more likely to mention things that others would procrastinate over until it was a far more serious problem.

* People who don't take HIV meds reliably... who might take them for a few days, forget a lot, might go for weeks, months, or years after running out before getting a refill, etc. These people tend to develop really bad resistance problems that snowball as they get older... they become resistant to more drugs, and the more drugs they have to take (and the more rigorous and less pleasant their drug options become), the more likely they are to take them inconsistently and develop even WORSE resistance. People in this group actually DO tend to still die from AIDS eventually, though not as quickly as people did back in the 80s and 90s.

* Someone who progressed all the way to full-blown AIDS before starting treatment (or began treatment back before modern drugs existed). These are the guys who "survived AIDS", but are never really going to be TOTALLY out of the woods (even if their immune system itself gradually regenerates) because HIV did so much secondary damage to their bodies that just won't ever really heal. For non-HIV examples, think about the tonsils of someone who gets strep infection after strep infection for years... eventually, their tonsils are going to be a pitted mass of scar tissue, voids, and smelly tonsil stones. Or someone who has endless sinus infections for years & ends up with sinuses that are scarred and damaged beyond repair. A long-term uncontrolled HIV infection causes nerve damage (including the brain), muscle wasting (including the heart), and the digestive system (including triggering autoimmune disorders, like Crohns, enabling the spread of HVP-induced anal cancer, etc).

The moral of the story: if you're at risk for HIV, get tested for it at least twice a year, and start meds immediately if you catch it. Do that, and you'll never "get AIDS". And if you ARE at high risk of catching HIV, take Truvada for PrEP to reduce your risk of catching HIV itself to almost zero.

And for the love of every deity you care about, if you have a teenage son who tells you he's gay... get him on PrEP NOW. Literally, call your doctor and make the appointment for him RIGHT NOW. Consider the relationship between birth control pills and teen pregnancy back in the 70s and 80s. Back in the 70s and 80s, teenage girls all BEHAVED as if they were "on the pill", but hardly any of them actually WERE. With entirely predictable results -- teen pregnancy EXPLODED. Today's gay teens all BEHAVE as if they're "on PrEP", but the overwhelming majority of them aren't. They NEED to be. Teen pregnancy didn't decline until GenX moms started putting their daughters on "the pill" the moment they had their first period.

Re:Puts the early claims into perspective

[Anonymous Coward]

> It is much more profitable to give patients lifetime treatments that repress the virus but do not cure the infection completely.

And the most profitable of all if you can sell an extraordinarily expensive cure that ultimately costs as much as 15-20 years of a blockbuster HIV drug, because THEN you capture and lock up the profit IMMEDIATELY instead of running the risk that a few years from now, someone else will invent a better drug and take away most of your market share (or your patents will expire, and cheap generics will take away what little market share you had left).

As an added bonus, if you manage to cure them... they can go out, get infected again, and you can sell them that same expensive cure a second time. A third time. Or more.

Consider: someone with HIV might today take a drug like Genvoya, which generates about $2,000/month in profits for Gilead (it sells for much more, but a lot of that ends up getting neutralized by rebates or soaked up by pharmacies as markup). That means someone with HIV who takes it is worth about $24,000/year to Gilead. In the best case, Gilead might make that amount for around 10 years before losing the revenue to a competitor's drug or generic alternative. That's $240,000. But remember, it's a POTENTIAL $240,000. There's always market risk that a better drug, or a health insurer's deal with a competitor, or whatever, might cut that short.

Now, look at the cost of the drug that cures Hepatitis C -- around $90,000 for a 12-week course of treatment. That's less than half of what Gilead could potentially make from our hypothetical HIV patient who takes Genvoya... but it's ALSO $90,000 that they're making RIGHT NOW and walking away with free & clear, without risk of having some competitor's drug take away the patient beforehand. And who knows... a non-insignificant portion of those HepC patients will ultimately prove to be really "good customers" who'll go out and catch it AGAIN, generating ANOTHER round of $90,000 refills.

The fact is, if a drug company comes up with a treatment regimen that genuinely "cures" HIV, they aren't going to try and "keep it off the market". They're going to market it with the loudest fanfare in the history of prescription drugs, and charge somewhere between $250k and a million dollars for the full course of treatment, knowing that they will INSTANTLY capture 99% of the market for HIV meds in first-world countries, because NO country or health insurer will be able to say no to them. And some of those cured patients will probably end up getting re-infected within months, let alone years, generating even more repeat business for them.

Re:Puts the early claims into perspective

[ceoyoyo]

Interestingly, the cure for type one diabetes, at least autoimmune types, is likely to be related to the cure for HIV infection.

Re:Puts the early claims into perspective

[gweihir]

I agree to most of what you say.

Medicine is still a lot of brute force over ignorance, though we'd rather not admit it.

And that not admitting it part is what I call hubris. I do agree that this is a personal opinion and that you can very well have a valid different opinion.

Re:Puts the early claims into perspective

[gweihir]

ACs that actually contribute anything worthwhile exist, but they are exceptionally rare. I wish /. has a "don't show me any AC postings" setting.

Re:Puts the early claims into perspective

[gweihir]

"Cured" and "can be successfully managed long-term" are very different things. Seriously.

Re:Puts the early claims into perspective

[Anonymous Coward]

> "Cured" and "can be successfully managed long-term" are very different things. Seriously.

No. "Managed" implies that there are still observable consequences and problems arising from that infection. As far as anyone can tell, if someone gets infected by HIV, discovers it within a few months, begins taking meds immediately, and reliably takes them for the rest of their life, their viral load will become undetectable within a few weeks, and they will never develop AIDS. So... "HIV" is being managed, but "AIDS" has, in fact, been decisively cured.

Whining about undetectable HIV infection is like bitching about nicotine addiction from vaping. Neither HIV addiction nor abstract nicotine addiction are GOOD things... but without AIDS (or literal cigarette smoking) to cause ACTUAL problems (like terminal illness), they're both almost an afterthought compared to life's bigger problems.

The fact is, if someone in a first-world country TODAY completely neglects their health to the point that they literally manage to progress all the way to honest-to-god AIDS before anyone notices or they DO anything about it, their HIV infection (and subsequent AIDS) is probably the LEAST of their immediate existential problems.

As a practical matter, if a middle-class white gay man in a first-world country becomes infected with HIV and begins treatment shortly thereafter, his HIV infection will be about as significant to his future health as cytomegalovirus infection (CMV is a virus that infects nearly everyone, but as far as anyone can tell, doesn't actually DO anything or directly cause any actual problems... it's basically a "do-nothing" virus).

Re:Oh FFS

[gweihir]

Well, here is to hoping you get it from a blood transfusion or a contaminated instrument. Unlike you, most scientists do actually have ethical standards, not just irrational hate.

Hodgkin's Lymphoma is not "Blood Cancer"

[lobiusmoop]

Hodgkins is a cancer in the immune/lymph system, which is a whole separate plumbing system to the blood stream. If it was in the blood stream it would be leukemia.

(21 years cancer free now, yay).

Re:Hodgkin's Lymphoma is not "Blood Cancer"

[Anonymous Coward]

Hodgkins is a cancer in the immune/lymph system, which is a whole separate plumbing system to the blood stream. If it was in the blood stream it would be leukemia.

(21 years cancer free now, yay).

Congrats.

But damn, dude, you're using your second chance at life to be a grammar pedant to BeauHD.

Either aim higher, or do us all a favor and use actual explosive devices.

Re: Hodgkin's Lymphoma is not "Blood Cancer"

[Anonymous Coward]

Oh ignore him. He is just angry his web subscription fee is being wasted reading these comments

Re:Hodgkin's Lymphoma is not "Blood Cancer"

[jonnythan]

Except white blood cells are indeed blood cells. Lymphoma is a blood cancer.

Lymphocytes are white blood cells. Leukemia translates to too many lymphocytes in the bloodstream and lymphoma translates to lymphocyte tumors. That means "leukemia" is too many white blood cells in the blood stream and "lymphoma" is white blood cell tumors.

So you are correct in saying that lymphomas are a cancer of the immune system, but incorrect in saying they're not blood cancers. They most definitely are. They are blood cell cancers. One is in the blood vessels and one is in, actually, both the lymphatic and blood vessels.

Congrats on being cancer free. That's pretty awesome.

Source: I'm a doctor.

Re:Hodgkin's Lymphoma is not "Blood Cancer"

[jonnythan]

Just to expand and add a few points:

The first line of the Wikipedia entry for lymphoma: "Lymphoma is a group of blood cancers that develop from lymphocytes (a type of white blood cell)."

The immune system is not a "separate plumbing system to the blood stream." All blood cells, including red blood cells and white blood cells (WBCs), originate in the bone marrow and migrate out to the blood stream. The immune system is comprised of many layers, but white blood cells are what we most commonly refer to as the immune system. There are WBCs that produce antibodies, WBCs that destroy other cells, etc. Many WBCs end up taking residence in lymph nodes. But the immune system is definitely not "a separate plumbing system." The lymphatic system is a separate plumbing system to the cardiovascular system (sort of; the lymphatics drain back into the blood vessels), but LYMPHATIC and LYMPHOCYTE are separate words.

Your confusion may be related to confusion between the words LYMPHATIC, LYMPHOCYTE, and LYMPHOMA. Lymphoma is a cancer of the lymphoCYTES, not necessarily the lymphATICS. Lymphomas tend to be primarily physically located within lymph nodes or lymph vessels, but they are cancers of the lymphocytes. Hence, they are blood cancers.

Re: Build a wall.

[Anonymous Coward]

Poor trolling 2/10.

Don't Listen to the Weasel Words

[Anonymous Coward]

"Clearing" does not equal "Curing," and "Resistance" does not equal "Immunity."

People with the Chemokine Receptor CCR5-D32 defect are not immune to HIV. They can still be infected, but it is just more difficult for the virus to replicate since it has to bind to a differetn co-receptor (usually CXCR4), so disease progress is slower. This is actually an evolutionary advantage for the HIV virus, because it can be spread to more people before it shows symptoms in the host.

CCR5 is an interesting approach to the management of HIV infection but IT IS NOT A CURE.

Re:Don't Listen to the Weasel Words

[omnichad]

That would indeed slow mutation and make it easier for the immune system to finish off. We'll have to wait and see.

Re:Oh FFS

[Anonymous Coward]

In addition, the few people I've known in my life who had this disease were drug addicts and/or sexually promiscuous, and not one one of the three was gay. One was from a dirty needle and she still doesn't know from where since no one else in her circle is infected, one was from a prostitute, and the other has no idea (but I suspect from time in military when he spent too much time in port in SE Asia)

Re:Oh FFS

[Anonymous Coward]

A precise and logical rebuttal. Well done!

Second opinion

[Anonymous Coward]

Why is everyone talking about "the London Patient, it's so romantic". God, that movie stunk!

"Cured" is wrong

[Anonymous Coward]

HIV is not a disease, it's just a virus. You can have viral load and be completely asymptomatic aka healthy. Which is why (I personally remember) the term HIV-positive was introduced to differentiate an HIV infection from AIDS. Might not have been the best choice because disassociating HIV from AIDS was fodder for denialists.

Re:"Cured" is wrong

[Anonymous Coward]

An asymptomatic infection is still a disease. Regardless, it is a bit disingenuous to write in the headline that a person is cured when the article says that it's too early to call that person cured.

Re:"Cured" is wrong

[Anonymous Coward]

Well, in that case, everyone who ever had chicken pox as a child is still technically "infected with a disease" (Herpes Zoster). It's just that under normal circumstances, it doesn't re-emerge after the initial primary infection. It can, however... and we even have an official name for it when it does: "Shingles"

Insofar as these two patients go, there's a reason why they're classified as "technically cured". HIV infects multiple organs and cells.

T-cells are the ones that tend to get noticed, because untreated HIV ultimately kills them off faster than they can be replaced. Eventually, the person ends up with almost no functioning immune system to speak of, and dies from some infection that would have otherwise been trivial to overcome.

There's a genetic mutation called ccr5-delta32 that involves the deletion of a protein HIV NORMALLY depends upon to recognize and infect T-cells. If a T-cell lacks the protein, most (~86% of strains found in the wild) can't infect it. Late in a HIV infection, the HIV often develops a mutation that enables it to infect T-cells that lack the protein... this is usually the point where the patient goes from "visibly sick" to "in hospice, waiting to die". On the bright side, HIV with this mutation isn't nearly as capable of establishing a new infection, so it rarely spreads directly (it's not impossible, but it doesn't happen very often... as a practical matter, it's only been observed to happen with people who HAVE a ccr5-delta32 mutation and can't become infected by any other strains... anyone else with similar exposure to HIV would just catch one of the more virulent strains LONG before a strain with its own CCR5 mutation was ever encountered).

Modern HIV meds are so effective at blocking the replication of HIV, they basically shut down the active infection by preventing its replication. Infected cells stay infected until they die and get swept away a few days/weeks later, but new, uninfected T-cells are continually produced. As long as HIV replication is suppressed, the immune system gradually recovers (though someone who was literally pulled from the brink of death after progressing all the way to clinical AIDS prior to starting treatment is likely to have serious medical problems for the rest of his or her life, due to other things that an uncontrolled HIV infection ravages in its later stages). That's why it's now considered to be so important to detect a HIV infection as soon as possible, and begin treatment immediately. If a new HIV infection is detected within a few weeks or months & treatment begins immediately to bring the HIV viral load down to undetectable levels, the patient's HIV is unlikely to cause future problems (as long as the patient continues to take his meds and remains undetectable).

The thing is, HIV doesn't JUST infect T cells. It establishes what's called a "viral reservoir" that we don't currently have the technology to treat (I believe it lies on the 'brain' side of the blood-brain barrier). HIV in the reservoir replicates slowly, but never completely stops. So... if someone with an undetectable viral load stops taking his meds, HIV from his viral reservoir basically re-infects him all over again.

Now, getting back to these two patients. They had leukemia. Their bone marrow was killed by radiation, and replaced by donor marrow from someone who had a double ccr5-delta32 mutation. The transplanted marrow produced T-cells that had the mutation. As a result, the HIV dripping into their bloodstream from their viral reservoir can no longer re-infect their T-cells. Ergo, "technical cure".

Think of it this way: imagine that a sadistic, evil mad doctor modified an insulin pump so that it could be filled with HIV-infected plasma and implanted in someone who doesn't have HIV... then gives the victim a lifetime supply of HIV meds and instructs them to take one daily to remain uninfected. Every few days, the pump randomly injects a drop of HIV-infected plasma into the victim's blood stream. If the victim is taking HIV meds, the

Re:"Cured" is wrong

[Anonymous Coward]

From what I can find, a "disease" and an abnormal condition that negatively affects the organism. If you're perfectly asymptomatic, then you're not negatively affected and therefore not a disease.

Re:"Cured" is wrong

[Anonymous Coward]

Thank you for the clear and detailed explanation.

I come here to read AC posts like this one.

Re:"Cured" is wrong

[sjames]

Increased likelihood of a future symptomatic condition is a negative effect.

Re:"Cured" is wrong

[Kyr Arvin]

Well, in that case, everyone who ever had chicken pox as a child is still technically "infected with a disease" (Herpes Zoster).

Yes, yes they are, we get tons of commercials where I live about Shingles that say as much.

Re: "Cured" is wrong

[Anonymous Coward]

go back to reddit

Re: "Cured" is wrong

[Anonymous Coward]

>_ go back to reddit

You know, Reddit has a lot of higher quality posts (questions and answers) these days. It is like Slashdot used to be around 2000.

Unfortunately, AFAIK, it doesn't accept AC posts. I've pondering about having a pen name account (which amounts to fake in my view, but then it might be the only way to participate).

I cannot "go back" there, at least for the moment.

What a shame

[Anonymous Coward]

How come we only cure useful diseases?

Re:What a shame

[Opportunist]

Like what, Polio?

Re: What a shame

[Anonymous Coward]

Too bad we can only treat ignorance and not cure stupid.

Re:Oh FFS

[Opportunist]

Funny enough, this attitude back in the 80s made the pandemic possible in the first place. Had we put a lid on it when it was still possible, AIDS would today be a problem of Africa, i.e. another one we ignore in the western world.

Oh no!

[Anonymous Coward]

HIV/AIDS is the cure for fags. Why are the scientists trying to undermine this. They are doing a great disservice to humanity is opening the gates of fag hell.

Dude, now when I'm in that threesome with the two hot babes, I won't have to worry too much if the bi-sexual girls did a bi-sexual guy and contracted HIV.

Let's face it, this is a real problem among us geeks: worrying about getting HIV from two hot babes we had sex with at the same time.

Re:Rejoice

[jellomizer]

And heterosexuals, people who may have been raped, children born from infected parent, people who have have a dirty needle (probably from drug use, but also from bad doctors), people who had a bad transfusion...
I know we want to think like our ancient ancestors did, seeing people with illnesses as being evil and less human. Combined with HIV most effective methods of spreading is due to taboo things just makes it seem like a punishment from God.
However if you are religious sort of person, you could also see HIV as a test to society on how we treat the least of the people, and for the people who see HIV as a punishment and do not try to cure it, or help the people, perhaps they are the one failing God.

If you are not a religious person, Then HIV is just an effective Virus, It was evolved in a way to be effective, and robust. Understanding Human Nature, where Taboo items will still happen, it means leaving such a virus in the open to try to curve "Deviant Behavior" will lead to number of getting infected even though they are not directly doing that particular behavior. Realizing the 7 degree of separation can cause such a virus from always being a possibility even for the most Pius among us.

Re:Oh FFS

[_merlin]

I'm going to be the stereotype here - the only person I knew who had HIV/AIDS was my uncle's boyfriend, and he died from it back in the early '90s when it was still a death sentence. I think a lot of people have become more blase about HIV now that you can go on living for years by taking a cocktail of anti-retroviral drugs. Back then, once you got HIV you were pretty much dead.

Triggering trolls

[Anonymous Coward]

Yet another reason for the trump's moronic trolls to get triggered; socialist healthcare by the NHS and subverting god's wrath.

Revel in your ignorance sweeties, kiss-kiss.

Awesome.... Can someone now....

[Anonymous Coward]

Awesome.... Can someone now invent a time machine and go find Freddie Mercury?

"Cured"

[Anonymous Coward]

Title: "Scientists Report a Second Person Has Been Cured of HIV"
Summary: "It's too early to say he's cured."

Contradiction

[Anonymous Coward]

Amazing ... the summary contradicts the title... oh wait :-) That's normal

good for him

[Anonymous Coward]

However please treat him as if he's still infected. As no one has any clue how this works yet and what fallout or repercussions might exist

Re: Oh FFS

[Anonymous Coward]

Butt fucking. It's deadly. Don't do it!

Mona Lisa Overdrive

[h00l00v00]

This gets me thinking about J.D Shapely from Mona Lisa Overdrive. Even though it seems much less intrusive to donate blood instead of blood marrow.

Re:Mona Lisa Overdrive

[sconeu]

Virtual Light, not Mona Lisa Overdrive.

Re:Oh FFS

[gweihir]

Well, the only thing you are demonstrating is that you are likely one of them and hate yourself for it. Basically only gays that are not at peace with what they are are violently and aggressively anti-gay.

We already have the cure...

[Anonymous Coward]

You just need to shoot up loads of cash.

Good news, but ...

[140Mandak262Jamuna]

Even the common chicken pox virus has learned to hide in lymph glands and re-emerge as shingles. Given the viral load caused by HIV, it is possible it too has learned to lurk in many places.

But, even if that is true, this is a good great advancement.

Re:Good news, but ...

[ceoyoyo]

That's why it's important that the donor bone marrow has an anti-HIV mutation. You're correct that HIV is pretty good at hiding out, but it needs to reproduce in T cells. If you replace all the T cells with ones that HIV can't infect, it can't come back.

Re:Good news, but ...

[Anonymous Coward]

If it's hidden enough for the guy to not get sick, and to not transmit the disease, who cares?

you got it wrong mr pedantic

[Anonymous Coward]

The bone marrow transplant halts and reverses a collapsing immune system. So you're wrong, this does treat and cure AIDS. if your viral load after a transplant is still present then you only temporarily releive AIDS and are mearly HIV infected at that point. If your immune system fully recovers and HIV is gone them you're cured.

Better Idea.

[Zorro]

Don't do stuff that gives you AIDS.

Re:Better Idea.

[sconeu]

You mean things like receive a blood transfusion?

Re: Better Idea.

[Anonymous Coward]

Yes. You can lower your risks by avoiding risky behavior.

It's really fucking simple. Why do you have trouble understanding it?

If blood transfusion is a vector, insist on transfusions from a known and tested source.

Re: Better Idea.

[sconeu]

Yeah, because when I'm brought into the ER and I'm unconscious, I'm really going to do that.

Re: Better Idea.

[Win0ver]

I'll make sure to ask the staff to use blood from a 'known and tested source' if I ever get in a car accident and lose enough blood to need a transfusion. Never mind the fact that I'll be unconscious and that a few minutes of delay means I'll die.

Re: Better Idea.

[BECoole]

Uh... Blood banks already test for HIV

Re: Better Idea.

[Anonymous Coward]

What kind of a third world country you live in where in current day and age blood from donors isn't tested for HIV?

Re: Oh FFS

[Opportunist]

Go and fuck a chick in Swaziland. Just don't do it in her ass and you should be all right.

They must have used vast quantities of NOVICHOK

[Anonymous Coward]

NOVICHOK doesn't kill, NOVICHOK cures all ailments! Especially in Small Britain.

How many times have we read this story?

[GodfatherofSoul]

Someone claims to have a cure to cancer or AIDS. Usually an overzealous reporter. Actual facts, it's some quirky edge case or someone looking for money.

I don't believe anyone has a cure to anything until they're selling the pill.

Being gay really is ok now.

[Anonymous Coward]

Government is finally curing the disease they made to genocide gay men. Looks like soon we'll be able to close that dark chapter of history.

unfortunately...

[slashmydots]

They haven't found a cure for the careless stupidity that lets people catch HIV in the first place. People that dumb are going to find a way to get themselves killed if they're that uncautious whether you cure their HIV or not.

Re:unfortunately...

[Major_Disorder]

They haven't found a cure for the careless stupidity that lets people catch HIV in the first place. People that dumb are going to find a way to get themselves killed if they're that uncautious whether you cure their HIV or not.

You mean "careless stupidity" like my childhood friend who got it from a blood transfusion after a car accident in which he was a passenger? Worthless sacks of shit like you make me sick.

Re:unfortunately...

[ffkom]

There may be people who get infected out of mindless stupidity, but there are also plenty who are infected without doing anything stupid, but just happen to have received medicine for hemophilia at the time it was unsafe, or lived a mundane sex life with a partner who happened to seek sexual adventures also elsewhere and so on...

Re: Rejoice

[Seewhatidonehere]

What the fuck are you going on about? All this rambling makes no sense whatsoever. Rejoice if you want to, but for the one percent of European population who is already immune to HIV by genetic default, all this is irrelevant.

Re: Rejoice

[Seewhatidonehere]

Eat ass every day

Re:Oh FFS

[angel'o'sphere]

Yeah, he does not understand that gays are not the problem but the solution!
So many lesbian women out of reach, sigh ... and many are so damn hot! So I'm happy about every gay not restricting the pool to pick from any further :P

Re:Rejoice

[sjames]

Your comment is well on target. In Jesus' day, leprosy was the "punishment from God" disease.

WWJD? Heal the lepers.

Re:Oh FFS

[gweihir]

Well, I would give you a "+1 Funny" for that if I could.

Re:Oh FFS

[Anonymous Coward]

you are a hideous sodomite and should be ashamed of yourself for spreading your feces based lifestyle to others. you are sick. god will judge you then damn you.

Re:Oh FFS

[angel'o'sphere]

And I thought it was "+1 Insightful" ... sigh.

WTF Magic Johnson was cured decades ago!!

[Anonymous Coward]

no way he still has AIDS

cured

[Anonymous Coward]

Title: "Person Has Been Cured"

TFS: "It's too early to say he's cured."

HIV Hope

[Anonymous Coward]

HOW I GOT CURED OF HIV VIRUS
It was 2015, when I was tested HIV Positive. In that time I was pregnant with my first child. In 2016, I gave birth to a healthy boy. At that time, I was taking the booster only.
In 2018, I started to get very sick. I took three months sick leave to recover.
I started to take ARV’s in 2018 but I was still very sick. My CD4 count was 130.
I started taking Herbal Medications from Dr. SANI in September 2018 and I was back at work at the end of October 2018 strong and healthy. My CD4 count came up to 609. I continued with the Herbal Treatment and eat healthy foods and fruits.
After finishing the Herbal Medicine In December 2018, Dr. SANI told me to go for medical checkup, and to my greatest surprise my Test result came out Negative and since then my joy know no bounds.
Now I am very strong and healthy, and HIV free, Herbal Medicine is magic.
People must believe in this ‘Herbal Medicines’. If it was not for the Herbal Medicines, I would still be struggling with the deadly Virus today. I hope everyone believes in Herbal Treatment. It can work for you too, if you believe in it and follow the prescriptions.
Contact DR. SANI
EMAIL: perfectherbalcure@gmail.com
Whatsapp: +2348118184266