Wall Street Journal: A HIV patient now "functionally cured" after bone marrow transpl

jamesdarlington

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Apparently a HIV infected person who also had lukemia recieved a bone marrow transplant to treat his lukemia and "appears to have won his battle with AIDS."

To make a long story short : In the treatment of lukemia doctors completely destroy your bone marrow cells by blasting them with radiation and chemtherapy, to ensure that all the cells are dead, so that no cancer can return. Bone Marrow cells are the cells that produce your white blood cells, your white blood cells ARE your immune system.

Once they killed of all the canceros (lukemia) bone marrow cells, they replaced them with the bone marrow cells from a donor who is naturally immune to HIV. And now that the HIV infected patient has bone marrow that produces white blood cells that are immune to HIV, he now has an immune system that is immune to HIV. Doctors have not detected HIV in his blood for over 600 days, even though he stopped taking all of his HIV meds since the marrow transplant. The doctors are saying that he is "functionally cured".

Now before you guys go out there and start having sex without using a condom because you think this is the cure for aids, keep this in mind. 30% of bone marrow transplants are fatal and some people are required to take immonosuppresant medication everyday for the rest of their lives to keep their immune system from killing the donor marrow. Having to take immonosuppresants is like having aids.

Here is the link A Doctor, a Mutation and a Potential Cure for AIDS - WSJ.com

Doctors have not been able to detect the virus in his blood for more than 600 days, despite his having ceased all conventional AIDS medication.

The breakthrough appears to be that Dr. Hütter, a soft-spoken hematologist who isn't an AIDS specialist, deliberately replaced the patient's bone marrow cells with those from a donor who has a naturally occurring genetic mutation that renders his cells immune to almost all strains of HIV, the virus that causes AIDS.

The mutation prevents a molecule called CCR5 from appearing on the surface of cells. CCR5 acts as a kind of door for the virus. Since most HIV strains must bind to CCR5 to enter cells, the mutation bars the virus from entering. A new AIDS drug, Selzentry, made by Pfizer Inc., doesn't attack HIV itself but works by blocking CCR5

Finally, he recommended standard second-line treatment: a bone marrow transplant -- but from a donor who had inherited the CCR5 mutation from both parents. Bone marrow is where immune-system cells are generated, so transplanting mutant bone-marrow cells would render the patient immune to HIV into perpetuity, at least in theory.

There were a total of 80 compatible blood donors living in Germany. Luckily, on the 61st sample he tested, Dr. Hütter's colleague Daniel Nowak found one with the mutation from both parents.

To prepare for the transplant, Dr. Hütter first administered a standard regimen of powerful drugs and radiation to kill the patient's own bone marrow cells and many immune-system cells. This procedure, lethal to many cells that harbor HIV, may have helped the treatment succeed.
The transplant specialists ordered the patient to stop taking his AIDS drugs when they transfused the donor cells, because they feared the powerful drugs might undermine the cells' ability to survive in their new host. They planned to resume the drugs once HIV re-emerged in the blood.

But it never did. Nearly two years later, standard tests haven't detected virus in his blood, or in the brain and rectal tissues where it often hides.

The case was presented to scientists earlier this year at the Conference on Retroviruses and Opportunistic Infections. In September, the nonprofit Foundation for AIDS Research, or amFAR, convened a small scientific meeting on the case. Most researchers there believed some HIV still lurks in the patient but that it can't ignite a raging infection, most likely because its target cells are invulnerable mutants. The scientists agreed that the patient is "functionally cured."
 

cityboy

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Wait!
Bone Marrow cells are the cells that produce your white blood cells, your white blood cells ARE your immune system.
So they completely destroy your cancerous bone marrow so that you have no immune system.

Once they killed of all the cancerous bone marrow cells, they replaced them with the bone marrow cells from a donor who is naturally immune to HIV.
So they replace immune system with a donor immune system that functions correctly? Right?

30% of bone marrow transplants are fatal and some people are required to take immunosuppressant medication everyday for the rest of their lives to keep their immune system from killing the donor marrow.
What? I thought you said they destroyed the original immune system and replaced it. If it was destroyed how come they have to take meds to keep a now supposedly now non-existent immune system from destroying what it was replaced with?
 

kabutops74

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Wait!
So they completely destroy your cancerous bone marrow so that you have no immune system.

So they replace immune system with a donor immune system that functions correctly? Right?

What? I thought you said they destroyed the original immune system and replaced it. If it was destroyed how come they have to take meds to keep a now supposedly now non-existent immune system from destroying what it was replaced with?

I'm not a biologist, but I think there's more to the immune system than white blood cells -- which were the only things specifically mentioned as deriving from bone marrow. So the immunosuppressants would be to keep the native immune system from flipping out over the new neighbors, as with many transplants.
 

jamesdarlington

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Wait!
What? I thought you said they destroyed the original immune system and replaced it. If it was destroyed how come they have to take meds to keep a now supposedly now non-existent immune system from destroying what it was replaced with?

Because sometimes the "new" donor immune system cells will start attacking the recepients tissue. In other words, the new white blood cells will think that everything around them, in this new body, is a foreign invader and they will start destroying it.

If this happens they will eat away at the major organs and kill the person if they do not take immunosuppresants.