I vaguely recall there was a case a few years back where a patient had been cured of HIV. But they had effectively their entire immune system wiped out by radiation therapy or something along those lines, and then received a bone marrow transplant from a healthy donor. So not something that could easily be replicated in many patients.
Still, that is big news, considering how many people have died from HIV, and how many still live with the virus. Treatment has come a long way - I remember how it was practically a death penalty in the 1990s; but a complete cure would be so much better than depending on medication for the rest of one's life. I don't think this is the breakthrough, but it is proof that search for a cure is not futile.
I think its been done a few times [1]. Crudely put: try to wipe out as much of the immune system then replace with stem cells from a donor. Previously they used donors who had a gene mutation that made them HIV resistant, but this was with 'normal' genes. But a stem cell transplant may have worse survivability than HIV for many people
Definitely not. Five year survival rate for stem cell transplants is about 50%. People with HIV now have effectively normal life expectancies provided that they're treated. Even if this worked reliably, it would be _very_ much a case of the cure being worse than the disease.
How much of that low survival rate is due to the condition they received the transplant, though? Conceivably a patient with "just" HIV might do better than one with eg. leukemia and HIV.
That said, IIUC the whole stem cell transplant procedure is unpleasant enough that it still might not be worth it.
If I’m reading this correctly it sounds like it might a kind of beneficial graft-vs-host reaction?
The HIV-free transplanted immune system sees the original immune system as alien, and proceeds to wipe it out at the cellular level. This presumably takes the HIV with it, even if the new immune system is not itself resistant.
I guess this means that quiescent HIV is not at a stage in its lifecycle where it can reinfect cells if its host cell is destroyed. My hilarious mental model of infectious HIV virions floating inside a CD4+ T-cell like angry bees inside a balloon is clearly mistaken.
People have to understand that individual cases of effectively curing HIV via stem cell transplants are merely providing a few puzzle pieces to HIV research, if at all, but have no clinical applicability, as a stem cell transplant is always an extreme, dangerous and last-resort treatment for otherwise unmanageable diseases, as which HIV generally does not count anymore.
Haven’t they done exactly this several times already?
Edit: Yep.
https://www.nature.com/articles/d41586-024-02463-w
It’s happened at least 5 times.
The novelty of this (not captured in the headline) is that the man received non-resistant stem cells .
I believe in all previous cases the donors had mutations of the CCR5 gene which made them resistant to HIV.
I vaguely recall there was a case a few years back where a patient had been cured of HIV. But they had effectively their entire immune system wiped out by radiation therapy or something along those lines, and then received a bone marrow transplant from a healthy donor. So not something that could easily be replicated in many patients.
Still, that is big news, considering how many people have died from HIV, and how many still live with the virus. Treatment has come a long way - I remember how it was practically a death penalty in the 1990s; but a complete cure would be so much better than depending on medication for the rest of one's life. I don't think this is the breakthrough, but it is proof that search for a cure is not futile.
I think its been done a few times [1]. Crudely put: try to wipe out as much of the immune system then replace with stem cells from a donor. Previously they used donors who had a gene mutation that made them HIV resistant, but this was with 'normal' genes. But a stem cell transplant may have worse survivability than HIV for many people
[1] https://www.nbcnews.com/health/health-news/7th-person-hiv-cu...
> I don't think this is the breakthrough
Definitely not. Five year survival rate for stem cell transplants is about 50%. People with HIV now have effectively normal life expectancies provided that they're treated. Even if this worked reliably, it would be _very_ much a case of the cure being worse than the disease.
How much of that low survival rate is due to the condition they received the transplant, though? Conceivably a patient with "just" HIV might do better than one with eg. leukemia and HIV.
That said, IIUC the whole stem cell transplant procedure is unpleasant enough that it still might not be worth it.
https://archive.ph/8e3sM
If I’m reading this correctly it sounds like it might a kind of beneficial graft-vs-host reaction?
The HIV-free transplanted immune system sees the original immune system as alien, and proceeds to wipe it out at the cellular level. This presumably takes the HIV with it, even if the new immune system is not itself resistant.
I guess this means that quiescent HIV is not at a stage in its lifecycle where it can reinfect cells if its host cell is destroyed. My hilarious mental model of infectious HIV virions floating inside a CD4+ T-cell like angry bees inside a balloon is clearly mistaken.
People have to understand that individual cases of effectively curing HIV via stem cell transplants are merely providing a few puzzle pieces to HIV research, if at all, but have no clinical applicability, as a stem cell transplant is always an extreme, dangerous and last-resort treatment for otherwise unmanageable diseases, as which HIV generally does not count anymore.
This is the 7th case, so this seems like a bigger puzzle piece.
How long before people find out the real source of stem cells.
Will they care?
Or will they throw it in the bucket with the cobalt mines.
three to five-day-old blastocysts and adult bone marrow?
Oh wow it's a lot less ominous if you just say it out loud instead of hiding behind your cape and making spooky noises huh.
I think this is random.