On Cure for HIV

According to German doctors, an American man with HIV may have been cured of his infection by a bone marrow transplant in Germany.

In 2007, the man received a bone marrow transplant to treat his leukemia. The transplant — which treats leukemia by essentially rebooting the body's immune system and creating new white blood cells —also had the benefit of wiping out the HIV infection. Now, three and a half years later, the patient remains HIV-free, which suggests he is cured of the disease, the researchers said.

"I'm extremely excited about the result," said Jerome Zack, a researcher at the University of California, Los Angeles, who studies HIV infection and was not involved in the study. "It suggests that at least in this one individual, there's a long-term benefit to this approach."

In the transplant, the patient received bone marrow, which contains blood stem cells, from a donor with a rare mutation. The mutation essentially prevents the most common form of HIV from getting inside certain immune cells, called T CD4 cells, and wreaking havoc on the immune system. Afterward, the virus appeared to stop replicating in the patient's body, and he no longer needed HIV antiretroviral medication.

The bottomline: Researchers' claim that a man has been cured of HIV is exciting and suggestive, but not conclusive.

Read more of Rachael Rettner's story on msnbc.com.

A preceding story "Possible Cure For AIDS On Horizon" was published last year on Febraury 25th, 2009 which stated:

In a spectacular display of medical serendipity, doctors have successful removed the HIV virus from a man by giving him a bone marrow transplant. Like others before it, this particular method seems to have arrived completely by accident; now, it seems researchers are compiling reports of patients becoming startlingly virus-free after receiving bone marrow transplants of a specific nature. The new case, which involves a 42-year-old American male, gives researchers the stimulation they need to discover gene therapy alternatives that could replace the antiretroviral drug cocktails in the long term – one relatively inexpensive treatment might have the power to clear up the viral problem for good.

The patient in this case was treated with antiretroviral drugs in Berlin for four years in order to keep the disease at bay. He subsequently developed leukemia, for which he was treated with a bone marrow transplant. Having had to stop the use the antiretroviral drugs in the process, doctors were surprised to discover that both diseases had no resurgence in two years; he is essentially disease-free since the transplant.

According to an article in the British-based Independent,

“The man’s treatment began with a search by doctors at Berlin’s Charité Hospital for a bone marrow donor with a genetic resistance to HIV. One of the strangest features of the disease is the way some people who have been exposed to the virus on many occasions remain uninfected. Twenty years ago, it was noticed that certain prostitutes in Nairobi remained uninfected despite exposure to the virus through thousands of sexual contacts.

It has since emerged that some people carry a mutation of a gene (CCR5) that confers protection against HIV. In Western populations an estimated one to three per cent have the mutation.”

Doctors then went on to find a bone marrow donor with the particular genetic resistance to HIV which they were seeking. This systematic and deliberate approach to ridding patients of the disease has much promise and should underlie efforts of researchers for the next several years.

The story's origin goes as for as three years ago. On 2008 skytv mentioned the story. And after 2 years, the subject becomes a hot topic again with no decisive ending.

HIV 'Cure' Risky and Impractical

Experts say treatment used to 'cure' the patient is dangerous and won't work for most.

"Although it may encourage hope that a cure is feasible, this approach in practice cannot be applied to the vast majority of patients," said Dr. Douglas Richman, director of the Center for AIDS Research at the University of California at San Diego.

The "cured" patient also had leukemia, and originally received a bone marrow transplant in 2007. The researchers, led by Dr. Gero Hutter of Charite-Medical University in Berlin, first reported the man's progress at a workshop last summer and published their findings in the current issue of the journal Blood.

But the patient's marrow donor turned out to be a special case. The donor had a mutation that prevented the virus from entering cells. Research has shown that people with this mutation are rarely infected with HIV, but finding such donors is difficult.

"These donor cells are rare. About one in 100 people in central Europe have this mutation," said Dr. Frank Spinelli, who's in private practice in New York.

"We should be clear that this 'cure' will in fact have almost no impact on the average HIV-infected patient," said Bert Jacobs, a professor at Arizona State University at Tempe.

Bone marrow transplants are also inherently risky to patients. A person's own damaged bone marrow is replaced by someone else's, and the marrow donor must be a match, and such matches are difficult to find.

The procedure is also very expensive and potentially dangerous, and with other effective treatments available, it may not be worth the risk.

"The mortality rate is approximately 30 percent when it is used in cancer patients," said Spinelli.

"With modern antiretroviral therapy there is little justification for attempting such a dangerous procedure to cure a disease that is often manageable," said Jacobs.

Despite Impractical Treatment, News Is Promising

"It provides early evidence ... of the concept that HIV infection can be cured," Dr. Margaret Fischl, a professor of medicine and director of the AIDS Clinical Research Unit at the University of Miami School of Medicine, wrote in an e-mail.

"I am excited about this case," said Spinelli. "After the stem cell transplant was performed, I expected the HIV viral reservoirs would reactivate over time, and this patient's blood would show an increase in HIV viral load. That has not happened."

In addition to possibly continuing to study the role of stem cells as a potential treatment for HIV, experts said the future of research seems very bright.

"Positive results from microbicide trails, male circumcision trials, vaccine trials and pre-exposure prophylaxis trials suggest that effective, relatively passive measures to minimize transmission of HIV may be on hand within the next decade," said Jacobs.

People living with HIV will also continue to benefit from medications that are generally easy to tolerate and help improve quality of life.

"Antiretroviral therapy has transformed HIV care over the past dozen years and represents one of the major medical accomplishments of the past few decades," said Richman.

Victor Maldonado is grateful for that.

"I'm currently on antiretrovirals, and the drugs work. There's no doubt about it," he said.

Even though he knows the patient in Germany is a rare case, he hopes that research like it will continue.

"Research is the lifeblood for finding treatments and a cure for HIV," he said.

Other Videos on Cure for HIV

HIV Immune Cells

Experts caution on HIV/Aids cure excitement

It could be too early for the public to start celebrating the news that a cure for the deadly HIV virus that causes Aids has finally been found, medical experts have warned.

It was reported last week that US-based scientists may have finally hit the home stretch in the long search for a cure for the disease that has ravaged nations, killing millions of people annually.

The US researchers said they have discovered a protein that can protect against a wide range of HIV, and that they now can design a vaccine against the incurable virus.

Dr Garry Nabel of National Institute of Allergy and Infectious Diseases, who led the US study, said the discovered proteins, called antibodies, are used by the bodies defence system to identify and neutralise foreign objects, such as bacteria and viruses.

“I am more optimistic about an Aids vaccine at this point than I have been probably in the last 10 years,’ Dr Nabel was quoted as saying, sparking unprecedented world-wide coverage of the discovery.

Welcoming the development, local medical experts and stakeholder in the HIV/Aids campaigns have termed it a positive development towards finding a cure for the scourge.

But Professor Fred Mhalu of the Muhimbili University of Health and Allied Sciences warned that it is too early for Tanzanians to celebrate, thinking that a cure for HIV/Aids has been found.

Professor Mhalu said there have been similar reports in the past, which are yet to fully yield anticipated and positive results.

“It is a stepping stone towards finding a final treatment, but I can’t say for sure it is already a solution, although prospects are truly high at such level,” he told the Sunday Citizen.

Professor Mhalu heads the university’s department of Microbiology and Immunology, which has also been involved in similar research for trials for a HIV/Aids cure using volunteers from the army. He said their research has gone through two stages with satisfying results.

Asked how long it could take for the US colleagues to confirm their case, Prof Mhalu said: “That is merely a protein antibody, let’s wait until a vaccine that can stimulate it is attained, you can’t say exactly how long.”

He said scientists will receive a clear picture during the forthcoming Aids vaccine conference scheduled for Atlanta, Georgia from September 28 to October 1.

The conference is a major venue for medical researchers, providing a forum, in which highest scientific HIV researches are presented and debated.

Meanwhile, the Tanzania network for religious leaders living with HIV/Aids (Tanerela) has expressed its optimism over the latest development.

“I have been following the debate and I am of the view that this time round we might have a cure,” said reverend Amin Sandewa, a former Luthran church living with HIV/Aids.

The impact of this, he said, is that they will have more people voluntary testing for their HIV status. “Many people now fear to test, but once we have the cure, I think, more people will come out and test,” he said.

For his part, the minister for Health and Social Welfare, Professor David Mwakyusa, said there is a need to check and make sure of some facts first.

Speaking over the telephone from Dodoma, Prof Mwakyusa said: “Usually we are guided by scientific journals, and the World Health Organisation. But now I would say what I have seen indicates preliminary reports.”

He added: “It is only when we go through them and convinced it is suitable for our country, we’ll be able to say much. There are things like costs and suitability of the cure to Tanzania.”

Efforts in the past to find a vaccine that could defeat the mutations of the virus have been almost impossible. Last September, researchers reported the biggest success yet with a vaccine that appeared to slow down the rate of infection by about 30 per cent among Thai volunteers.

But the trial left many questions unanswered. Scientists have been looking for parts of the virus that do not mutate, so they can design a vaccine that will protect against the constantly changing versions.