*** Possible Cure For HIV; yeah that's right, you did just read correctly ***

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    Jun 16, 2012 9:14 PM GMT
    There has been a reported case of a man with previously diagnosed HIV who, after a bone marrow transfusion, has now no longer any HIV in his system.

    If this newly found method leads to a cure that is available for the masses, how effing awesome.




    Top AIDS scientists are scratching their heads about new data from the most famous HIV patient in the world — at least to people in the AIDS community.

    Timothy Ray Brown, known as the Berlin patient, is thought to be the first patient ever to be cured of HIV infection.

    Brown, 45, had two bone marrow transplants in Berlin in 2007 and 2008 to treat leukemia that is apparently unrelated to his HIV infection. The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells. Details about his case were published in the New England Journal of Medicine.

    The transplants appear to have snuffed out Brown's HIV infection. After an initial spike, the stubborn virus disappeared from his system — even though he is no longer taking anti-HIV drugs.

    But new data presented last week in Spain raise a question about whether there are minute traces of HIV in some tissues — not whole virus capable of replicating, but pieces of viral genes.


    Researchers have combed through 9 billion of Brown's cells, retrieved from his blood, lymph nodes, spinal fluid and intestinal tract. Four different labs could find no trace of HIV in his blood cells. But three groups, using tests at the very limit of detectability, think they have identified bits of HIV genetic material — two from blood plasma and one from intestinal cells.

    It could be a false reading, due to laboratory contamination, scientists say. For one thing, the fragments of viral genes don't completely match those of the HIV Brown harbored before his transplants.

    "Although the subject has had intermittent evidence for HIV persistence in some assays in some laboratories," the researchers wrote in a summary, "the extremely low levels of virus which were detected, while pushing the limits of sensitivity and specificity ... make it impossible to conclude that the subject remains HIV-infected."

    Dr. Douglas Richman of the University of California, San Diego, who found no hint of HIV in Brown's cells, thinks the signals are due to laboratory contaminants. If you do enough runs of these ultra-sensitive tests, Richman told Science magazine's ScienceInsider blog, "you can get a signal in water for pink elephants."

    Scientists at the University of California, San Francisco, who are following Brown most closely, declined to comment publicly, citing his confidentiality as a patient and research subject.

    But AIDS researchers — and Brown himself, in an interview with Shots — stress that even if the new findings constitute real evidence of HIV in his system, they don't mean he's not cured. Although, it's clear the findings do raise questions about what sort of cure he has.

    Scientists hoped Brown had a so-called sterilizing cure — that is, the HIV has been completely eradicated from every cell in his body.

    But long and bitter experience with HIV has shown that the virus can hide out in the genes of very long-lived resting immune cells. As these latently infected cells get activated over the years, HIV might reappear in the form of the whole virus or perhaps pieces of its genes.

    But if that is happening in Brown, there is no evidence that the virus is actively replicating. To do that, it would need to infect other cells and hijack their genetic machinery to crank out more virus. Since Brown's replacement immune system (from the bone marrow donor) doesn't have the entry portal HIV needs, these new viruses (if they exist in his case) can't spark a new viral conflagration.

    Therefore, he may be functionally cured, even if he's not totally free of HIV.

    That's what Brown himself thinks may be going on, from his discussions with researchers who have been poking and prodding him for the past five years.

    "With a sterilizing cure, they have to be sure that a patient is completely clear of HIV — that they've looked everywhere and can't find any," Brown says. "In my case, I still have the dead virus and it's still showing up in some ways, and so I've got a functional cure."

    To him, that's just as good.

    But Brown is distressed at the suggestion by some bloggers — in particular a French AIDS researcher named Alain Lafeuillade of the General Hospital in Toulon — that he's not truly cured.

    "It's not the case, but people are spreading it," Brown says. "That concerns me because I've been told by many people that I give them hope — people who have HIV. And that's what I want to do. I want to be able to continue spreading my message and be able to do that without having conflicts of people who are misinterpreting the truth."

    Brown is particularly upset at suggestions that he has become reinfected with HIV through unsafe sex. "That is not the case," he says. "It's very difficult for me to listen to those things and read those things."

    The latest findings are sure to be debated among AIDS researchers and advocates. Their main significance is to show how tricky it will be to determine exactly what constitutes a cure, as researchers devise various tricks to cure AIDS with less drastic means than bone marrow transplants. The question is, when can they be reasonably sure a cure has occurred?

    For his part, Brown says he'll continue to be a guinea pig for as long as it takes if he can help resolve that big question.

    "Hopefully one day I won't have to do it anymore," he says, because he'll just be one of many cured patients. "That would be nice."



    http://www.npr.org/blogs/health/2012/06/13/154869103/traces-of-virus-in-man-cured-of-hiv-trigger-scientific-debate



    [28th July 2012; EDIT: More patients have undergone a succesful treatment and are cured of HIV.

    http://abcnews.go.com/blogs/health/2012/07/26/two-more-patients-hiv-free-after-bone-marrow-transplants/: ]
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    Jun 16, 2012 9:16 PM GMT
    Thoughts?
  • nanidesukedo

    Posts: 1036

    Jun 16, 2012 9:21 PM GMT
    _SAGE_ saidThoughts?


    No and No.

    A. Finding a match with the appropriate mutations = difficult as can be.

    B. Killing off someone's bone marrow in order to prepare for Bone Marrow Transplant = very, very dangerous. Lack of Red blood cell, platelet, and white blood cell production..

    C. Risk of graft vs host disease that would necessitate lifetime of medication in many patients..

    This guy needed bone marrow transplant to treat another condition and just got amazingly lucky with the donor having the appropriate mutation of the receptors (rare in of itself, so finding a match with this = exceedingly rare).

    This being a workable cure - no and no a million times over. No one should be getting any sort of hope up. Not at all.
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    Jun 16, 2012 9:50 PM GMT
    nanidesukedo said
    _SAGE_ saidThoughts?


    No and No.

    A. Finding a match with the appropriate mutations = difficult as can be.

    B. Killing off someone's bone marrow in order to prepare for Bone Marrow Transplant = very, very dangerous. Lack of Red blood cell, platelet, and white blood cell production..

    C. Risk of graft vs host disease that would necessitate lifetime of medication in many patients..

    This guy needed bone marrow transplant to treat another condition and just got amazingly lucky with the donor having the appropriate mutation of the receptors (rare in of itself, so finding a match with this = exceedingly rare).

    This being a workable cure - no and no a million times over. No one should be getting any sort of hope up. Not at all.


    As things in medicine currently stands, I'd agree that you have valid doubts, but this does not mean this will always be the case.

    I'd be very surprised if positive knowledge of this method actually working does not lead to further research and developments down this line of treatment.

    A. - Finding an appropriate match will of course be difficult, but not impossible. Also, with advanced improvements in stem cell medicine, it may be possible to generate/reproduce appropriate cells within a lab facility- as opposed to being dependent on repeat donors. How far off this is from being feasible, I don't know, but surely this is step in the right direction and motivation for further funding and fervent study within this field.

    http://news.bbc.co.uk/1/hi/health/4120829.stm

    B + C. - Similarly, with the advancement of medical knowledge/technology that decreases the odds of associated risks this type of procedure entails, this type of treatment should, logic dictates, become more and more feasible.

    I'd also be curious to know what doctors who have undergone research in HIV treatment/cure make of this possible development, and what can possibly be built upon this finding.

  • nanidesukedo

    Posts: 1036

    Jun 16, 2012 10:01 PM GMT
    _SAGE_ said
    nanidesukedo said
    _SAGE_ saidThoughts?


    No and No.

    A. Finding a match with the appropriate mutations = difficult as can be.

    B. Killing off someone's bone marrow in order to prepare for Bone Marrow Transplant = very, very dangerous. Lack of Red blood cell, platelet, and white blood cell production..

    C. Risk of graft vs host disease that would necessitate lifetime of medication in many patients..

    This guy needed bone marrow transplant to treat another condition and just got amazingly lucky with the donor having the appropriate mutation of the receptors (rare in of itself, so finding a match with this = exceedingly rare).

    This being a workable cure - no and no a million times over. No one should be getting any sort of hope up. Not at all.


    As things in medicine currently stands, I'd agree that you have valid doubts, but this does not mean this will always be the case.

    I'd be very surprised if positive knowledge of this method actually working does not lead to further research and developments down this line of treatment.

    A. - Finding an appropriate match will of course be difficult, but not impossible. Also, with advanced improvements in stem cell medicine, it may be possible to generate/reproduce appropriate cells within a lab facility- as opposed to being dependent on repeat donors. How far off this is from being feasible, I don't know, but surely this is step in the right direction and motivation for further funding and fervent study within this field.

    http://news.bbc.co.uk/1/hi/health/4120829.stm

    B + C. - Similarly, with the advancement of medical knowledge/technology that decreases the odds of associated risks this type of procedure entails, this type of treatment should, logic dictates, become more and more feasible.

    I'd also be curious to know what doctors who have undergone research in HIV treatment/cure make of this possible development, and what can possibly be built upon this finding.



    You still have to kill off the bone marrow...Killing off bone marrow will NEVER be without a considerable amount of risk. Also, even if medical advancements arise that allow for medication that better allows the body to cope with graft vs host disease, you've now just taken them off incredibly beneficial HAART therapy, put them through a fairly (I'm being awfully kind by only calling it fairly risky) risky procedure, and put them on a different medication (which is more toxic than HAART therapy).

    The gain does not outweigh the risk in this case - and almost assuredly never will. As for the mutations that prevent the spread of HIV, this has been known for a long time now - there are some interesting biologic therapies in the works that hope to target these receptors and, by occupying or possibly even disabling them, prevent invasion of the HIV virus into white blood cells.

    Destroying someone's own bone marrow completely for the chance of possibly giving them someone's bone marrow who is homozygous for the mutation...finding the absolute perfect match (or, if possible, in the future, creating it )..or enduring a lifetime of medication if and only if the graft isn't right out rejected...it's just not feasible as a treatment for something else that already has an amazing treatment.

    In the age of HAART, where the drugs have become more effective and less toxic and are being refined every few years with more and more options, the standard and bar are set very, very high for what constitutes an effective treatment or "cure" will consist of.
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    Jun 16, 2012 10:20 PM GMT
    Already immune.

    Thanks. :-)
  • Posted by a hidden member.
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    Jun 16, 2012 11:00 PM GMT
    LIEV saidAlready immune.

    Thanks. :-)


    Really? Prove it ...

    Syringe_with_blood.jpg

    =]

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    Jun 16, 2012 11:22 PM GMT
    Morbitity with a BMT depending on reason of transplant is very high and often has life changing side affects.

    The above poster JUST scratched the surface of some of the problems. I'm very close to many many people who have had the treatment for a multitude of reasons with poor results and while a success one included one of my loved ones.
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    Jun 16, 2012 11:24 PM GMT
    nanidesukedo said
    _SAGE_ said
    nanidesukedo said
    _SAGE_ saidThoughts?


    No and No.

    A. Finding a match with the appropriate mutations = difficult as can be.

    B. Killing off someone's bone marrow in order to prepare for Bone Marrow Transplant = very, very dangerous. Lack of Red blood cell, platelet, and white blood cell production..

    C. Risk of graft vs host disease that would necessitate lifetime of medication in many patients..

    This guy needed bone marrow transplant to treat another condition and just got amazingly lucky with the donor having the appropriate mutation of the receptors (rare in of itself, so finding a match with this = exceedingly rare).

    This being a workable cure - no and no a million times over. No one should be getting any sort of hope up. Not at all.


    As things in medicine currently stands, I'd agree that you have valid doubts, but this does not mean this will always be the case.

    I'd be very surprised if positive knowledge of this method actually working does not lead to further research and developments down this line of treatment.

    A. - Finding an appropriate match will of course be difficult, but not impossible. Also, with advanced improvements in stem cell medicine, it may be possible to generate/reproduce appropriate cells within a lab facility- as opposed to being dependent on repeat donors. How far off this is from being feasible, I don't know, but surely this is step in the right direction and motivation for further funding and fervent study within this field.

    http://news.bbc.co.uk/1/hi/health/4120829.stm

    B + C. - Similarly, with the advancement of medical knowledge/technology that decreases the odds of associated risks this type of procedure entails, this type of treatment should, logic dictates, become more and more feasible.

    I'd also be curious to know what doctors who have undergone research in HIV treatment/cure make of this possible development, and what can possibly be built upon this finding.



    You still have to kill off the bone marrow...Killing off bone marrow will NEVER be without a considerable amount of risk. Also, even if medical advancements arise that allow for medication that better allows the body to cope with graft vs host disease, you've now just taken them off incredibly beneficial HAART therapy, put them through a fairly (I'm being awfully kind by only calling it fairly risky) risky procedure, and put them on a different medication (which is more toxic than HAART therapy).

    The gain does not outweigh the risk in this case - and almost assuredly never will. As for the mutations that prevent the spread of HIV, this has been known for a long time now - there are some interesting biologic therapies in the works that hope to target these receptors and, by occupying or possibly even disabling them, prevent invasion of the HIV virus into white blood cells.

    Destroying someone's own bone marrow completely for the chance of possibly giving them someone's bone marrow who is homozygous for the mutation...finding the absolute perfect match (or, if possible, in the future, creating it )..or enduring a lifetime of medication if and only if the graft isn't right out rejected...it's just not feasible as a treatment for something else that already has an amazing treatment.

    In the age of HAART, where the drugs have become more effective and less toxic and are being refined every few years with more and more options, the standard and bar are set very, very high for what constitutes an effective treatment or "cure" will consist of.


    The gain may never fully outweigh the risk with this procedure (as is), but that doesn't change the possibility that a cure now exists- irrespective of it's feasibility.

    Nothing, as is known, bars the possibility that this type of treatment will be fine-tuned and advanced in such a way so that the risks do not outweigh the gain in the future, possibly via methods that are not yet even recognised by the greatest minds in medicine of today.

    We cannot rule out the possibility of an event occurring, a priori or a posteriori, when we cannot categorically disprove it- no matter how likely we assume it to be.

    The doctors of any period of time will never be able to certainly know what medical advancements will take place in the future, even when the generally respected and widely held medical opinion is based upon experience or probable deduction.

    I am interested in the current biological therapies on HIV receptors being studied you refer to though. I'll be sure to have a look for some data on these.
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    Jun 16, 2012 11:25 PM GMT
    This has been known in like months
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    Jun 16, 2012 11:27 PM GMT
    joe_diesel1 saidMorbitity with a BMT depending on reason of transplant is very high and often has life changing side affects.

    ...


    As medicine currently stands. Yes.
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    Jun 16, 2012 11:27 PM GMT
    Hunahpu saidThis has been known in like months


    Really? Your point being what exactly? =]
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    Jun 16, 2012 11:38 PM GMT
    _SAGE_ said... The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells. ...
    If they (scientists) can identify that mutation and replicate it so that a transfusion is not needed, that would be great!
  • Posted by a hidden member.
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    Jun 16, 2012 11:38 PM GMT
    Hunahpu saidThis has been known in like months
    I didn't know it till now. Take your better-than-you attitude elsewhere.
  • nanidesukedo

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    Jun 16, 2012 11:40 PM GMT
    paulflexes said
    _SAGE_ said... The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells. ...
    If they (scientists) can identify that mutation and replicate it so that a transfusion is not needed, that would be great!


    They know the mutation and have known it for years - it's the target of a lot of in the works biologic and gene therapy.
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    Jun 16, 2012 11:52 PM GMT
    nanidesukedo said
    paulflexes said
    _SAGE_ said... The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells. ...
    If they (scientists) can identify that mutation and replicate it so that a transfusion is not needed, that would be great!


    They know the mutation and have known it for years - it's the target of a lot of in the works biologic and gene therapy.


    Hopefully these studies can/will be further advanced by the recent development of The Berlin Man, or vice versa.
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    Jun 16, 2012 11:53 PM GMT
    paulflexes said
    _SAGE_ said... The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells. ...
    If they (scientists) can identify that mutation and replicate it so that a transfusion is not needed, that would be great!


    Agreed! =]
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    Jun 17, 2012 12:06 AM GMT
    [blockquote][cite]paulflexes said
    _SAGE_ said... The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells. ...
    If they (scientists) can identify that mutation and replicate it so that a transfusion is not needed, that would be great!
    [/quote]
    There are 4 clinical courses of HIV. The longterm nonprogressors, people who show a normal immune response and CD4 counts but low viremic numbers, have mutations in CCR5 receptors which are needed for West Nile. There are several drugs targeted for this receptor, they are working on gene therapy for this.

    I aggree with the above posters who gave good reasons that bone marrow transplant is not a viable option for HIV treatment.

    The mutation in this receptor is only present in maybe 100s of people around the world. This limitation along with matching antigens between recipient and donor limits bone marrow transplantation.

    Gene therapy leading to stem cell growth of healthy, viable cells with the CCR5 mutation for bone marrow enough to replace in another person is decades away, if possible.
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    Jun 17, 2012 12:28 AM GMT
    "Creativity requires the courage to let go of certainties."
    — Erich Fromm
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    Jun 17, 2012 12:43 AM GMT
    nanidesukedo said No one should be getting any sort of hope up. Not at all.


    You should be a grant proposal writer for medical research organizations.
  • nanidesukedo

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    Jun 17, 2012 12:58 AM GMT
    Ariodante said
    nanidesukedo said No one should be getting any sort of hope up. Not at all.


    You should be a grant proposal writer for medical research organizations.


    Been there, done that... Institutional Review Boards suck...something about human safety this and the other. icon_biggrin.gif
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    Jun 17, 2012 1:09 AM GMT
    nanidesukedo said
    Ariodante said
    nanidesukedo said No one should be getting any sort of hope up. Not at all.


    You should be a grant proposal writer for medical research organizations.


    Been there, done that... Institutional Review Boards suck...something about human safety this and the other. icon_biggrin.gif
    #

    I hear the leech wielding doctors/hair barbers of the middle ages thought the same thing, in regards to neuro-surgery ;D
  • nanidesukedo

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    Jun 17, 2012 1:12 AM GMT
    METAMORPH said
    nanidesukedo said
    Ariodante said
    nanidesukedo said No one should be getting any sort of hope up. Not at all.


    You should be a grant proposal writer for medical research organizations.


    Been there, done that... Institutional Review Boards suck...something about human safety this and the other. icon_biggrin.gif
    #

    I hear the leech wielding doctors/hair barbers of the middle ages thought the same thing re neuro-surgery ;D


    There's a lot of promising things out there for HIV - point blank is this: It's not Bone Marrow Transplant.

    This case has been around for months. It's been known for months that he was "cleared" due to the mutation of his donor.

    There's a really, really good reason that hematologist/oncologists, infectious disease doctors, and the like aren't rushing to send their HIV+ and AIDS patients off to try to receive similar therapy.


    Is it a fun and cool clinical case? Yes. Is it the future of treatment when vaccines, new anti-retrovirals, biologic therapy, and gene therapy, which would be much safer, are in the works? Not by a long shot.

    To do bone marrow transplant, you have to make someone pancytopenic - which is another word for your red blood cells, your white blood cells, and platelets are no longer being produced. It's a bad position to put a patient in - BMT is only used on patients as an option of last resort when other therapies have not been effective. The morbidity and mortality is high.

    In this day and age, if HIV/AIDs is caught early enough, there is a huge likelihood that, on effective HAART, that you will not die of HIV/AIDs. Patients on effective therapy do not die of HIV/AIDs - they die of other things.

    The idea of exposing people to BMT when such therapies are available is ludicrous.

    An IRB wouldn't allow trials for any treatment that would have such high morbidity and mortality when such effective treatment already exists - they only allow for treatment that is "safe (read: low side-effects or bearable, at least) in animal and controlled human trials.
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    Jun 17, 2012 1:16 AM GMT
    Hunahpu saidThis has been known in like months


    Yep, the initial reports are from 2011. And doctors said from the beginning that this is not a therapy that can be used for many people, if that.

    But really strange that we are discussing this NOW, as I read this about the patient only this week:
    http://www.huffingtonpost.com/2012/06/13/timothy-ray-brown-hiv-not-cured-virus-traces_n_1593190.html

    Cure for HIV? Maybe not completely....
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    Jun 17, 2012 1:17 AM GMT
    nanidesukedo said
    METAMORPH said
    nanidesukedo said
    Ariodante said
    nanidesukedo said No one should be getting any sort of hope up. Not at all.


    You should be a grant proposal writer for medical research organizations.


    Been there, done that... Institutional Review Boards suck...something about human safety this and the other. icon_biggrin.gif
    #

    I hear the leech wielding doctors/hair barbers of the middle ages thought the same thing re neuro-surgery ;D


    There's a lot of promising things out there for HIV - point blank is this: It's not Bone Marrow Transplant.

    This case has been around for months. It's been known for months that he was "cleared" due to the mutation of his donor.

    There's a really, really good reason that hematologist/oncologists, infectious disease doctors, and the like aren't rushing to send their HIV+ and AIDS patients off to try to receive similar therapy.


    Is it a fun and cool clinical case? Yes. Is it the future of treatment when vaccines, new anti-retrovirals, biologic therapy, and gene therapy, which would be much safer, are in the works. Not by a long shot.


    I'm not saying that is is, necessarily. Not with what is known in medicine is now, that is.

    However, I don't rule out that this discover can lead to something more.

    There is nothing to suggest that today's medicine cannot evolve to a place where current paradigms shift, and important advances allow for procedures that are currently risk prohibitive. Or for current procedures to be fine-tuned so that they are not as risky as they currently are, right now.

    That is my point, and you have seemed to have missed/ignored it.