Follow Up: First man ever cured of HIV still healthy, still cured

gettheleadout

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ElChamaco

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WOW! How has this not been picked up by mainstream media? Now if only we could distribute all our awesome medical technological equitably across the world...
 

ElChamaco

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1. It has before

2. BMTs are not a walk in the part: they are highly risky and expensive.
Ah... I didn't realize that because the journal article referenced was only accepted 11 days ago. Ah well... We have the meds to effectively manage AIDs in most cases as it is. My comment on equitable distribution of medical technology still applies.
 
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gettheleadout

gettheleadout

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1. It has before

2. BMTs are not a walk in the part: they are highly risky and expensive.
Yeah its not practical as a common treatment for various reasons, but I think its a significant accomplishment in and of itself.
 

Drrrrrr. Celty

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Bone marrow transplants also involve destroying the hosts immune system. In HIV patients that's incredibly dangerous (I'm still surprised how this happened). Not to mention this guy lucked out, only 11% of Europeans have this glycoprotein abnormality. We do have great methods of treating AID/HIV including HAART, however it's also one of the most costly drug cocktails in the world. Good luck trying to get that to HIV patients in 3rd world countries.
 
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Hah

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Bone marrow transplants also involve destroying the hosts immune system. In HIV patients that's incredibly dangerous (I'm still surprised how this happened). Not to mention this guy lucked out, only 11% of Europeans have this glycoprotein abnormality. We do have great methods of treating AID/HIV including HAART, however it's also one of the most costly drug cocktails in the world. Good luck trying to get that to HIV patients in 3rd world countries.
How is it more dangerous if a HIV patient's immune system is destroyed? I thought HIV infects the immune system effectively destroying it. HIV patients are only in danger because they lack an effective immune system and are suceptible to opportunistic infections. I would argue that destroying a host immune system in a normal person and an HIV infected person is the same in terms of how dangerous it is. The end result in both is someone who is highly suceptible to infections and needs to live in a bubble. I mean your essentially destroying the host cells for HIV.

This is a great step towards a cure (if we ever get there) but I'd have to agree this individual got quite lucky to find a donor who was homozygous for the CCR5{delta}32 mutation.
 
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Drrrrrr. Celty

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How is it more dangerous if an HIV patient's immune system is destroyed? I thought HIV infects the immune system effectively destroying it. HIV patients are only in danger because they lack an effective immune system and are suceptible to opportunistic infections. I would say that destroying a host immune system in a normal and an HIV infected person is the same in terms of how dangerous it is. The end result in both is someone who is highly suceptible to infections and needs to live in a bubble.
I will explain in an analogy. Pretend you're a general leading an army and you just got totally pwned by the other guy. Then you decide to kill half of you're army because you've got self loathing problems and try to take the other guy on again. It's not smart right? That's effectively what you're doing in this situation. You're effectively damaging your already damaged immune system and then demanding it to deal with an enemy which you couldn't defeat in the first place. You're simply killing yourself quicker.
The difference between a non-HIV host is that there isn't any army that's going to massacre you if it is given the chance. Your people have time to rest and then reproduce and make more soldiers (T-cells) to defend yourself in a while. The HIV host will not have the time to reproduce more T-cells because there are a lot of HIV virus's which will quickly kill them and even if any new T-cells are made in the spongy bone they will quickly become useless.
 
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Hah

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I will explain in an analogy. Pretend you're a general leading an army and you just got totally pwned by the other guy. Then you decide to kill half of you're army because you've got self loathing problems and try to take the other guy on again. It's not smart right? That's effectively what you're doing in this situation. You're effectively damaging your already damaged immune system and then demanding it to deal with an enemy which you couldn't defeat in the first place. You're simply killing yourself quicker.
The difference between a non-HIV host is that there isn't any army that's going to massacre you if it is given the chance. Your people have time to rest and then reproduce and make more soldiers (T-cells) to defend yourself in a while. The HIV host will not have the time to reproduce more T-cells because there are a lot of HIV virus's which will quickly kill them and even if any new T-cells are made in the spongy bone they will quickly become useless.
I'm assuming your refering to the recovery of the immune system after a bone marrow transplant of an HIV positive patient. You make a good point however, there has been recent studies that show HIV patients undergo bone marrow transplants very well (http://www.medscape.com/viewarticle/413256). Your assuming that HIV patients with high viral loads go in and have BMT and thats just not the case. In most cases, HIV patients who have a seperate problem such as malignancies tolerate the procedure well because their HIV load is well controlled and the immune system is able to recover under such conditions.

Though this is all just being all too specific and anal...... I get where your coming from ^_^
 

transfec

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I will explain in an analogy. Pretend you're a general leading an army and you just got totally pwned by the other guy. Then you decide to kill half of you're army because you've got self loathing problems and try to take the other guy on again. It's not smart right? That's effectively what you're doing in this situation. You're effectively damaging your already damaged immune system and then demanding it to deal with an enemy which you couldn't defeat in the first place. You're simply killing yourself quicker.
The difference between a non-HIV host is that there isn't any army that's going to massacre you if it is given the chance. Your people have time to rest and then reproduce and make more soldiers (T-cells) to defend yourself in a while. The HIV host will not have the time to reproduce more T-cells because there are a lot of HIV virus's which will quickly kill them and even if any new T-cells are made in the spongy bone they will quickly become useless.
Ugh.... Don't militaristic metaphors do enough harm in the medical field already? Let's stay away from them.
 

ElChamaco

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Who the hell is 'we' numnuts?
Why so ill-tempered all the time cbrons? Do yo use SDN as your stress relief?

We = those with advanced medical technology, wealthy nations, etc, etc...
 

Dirt

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I would like to know the odds of finding an unrelated, CCR5 homozygote mutant, HLA matched, BMT donor. It's like winning the AIDS powerball.
 
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The article cannot claim 100% cure. During his infection, the HIV virus could have penetrated his nervous system via macrophages, one of the main targets of HIV. The problem with the virus is that it remains assymptomatic for so long and CNS target can happen very early during infection even before seroconversion. If the scientist were able to replace his entire immune system without a single HIV virus escaping into his central nervous system, then he would be entirely cured considering his immune system was replaced. this pt was very lucky in that he was able to find a perfect match, something extremly difficult to do. Good attempt nontheles.
 
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I would like to know the odds of finding an unrelated, CCR5 homozygote mutant, HLA matched, BMT donor. It's like winning the AIDS powerball.
This is exactly what I was thinking. Very interesting article though for sure.
 

Drrrrrr. Celty

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The article cannot claim 100% cure. During his infection, the HIV virus could have penetrated his nervous system via macrophages, one of the main targets of HIV. The problem with the virus is that it remains assymptomatic for so long and CNS target can happen very early during infection even before seroconversion. If the scientist were able to replace his entire immune system without a single HIV virus escaping into his central nervous system, then he would be entirely cured considering his immune system was replaced. this pt was very lucky in that he was able to find a perfect match, something extremly difficult to do. Good attempt nontheles.
How do you replace a whole immune system? :confused:
Basically more or less he's gotten a nice BMT of red spongy bone which is now producing white blood cells which have a mutated glycoprotein receptor on their surface. The HIV virus cannot attack these cells, thus he's more or less fine. However while HIV could have gotten into the CNS as long as his astrocytes and other components of his immune system can fend off meningitis or other diseases from entering the CNS he'll be fine.
Also it wasn't an attempt to cure his HIV. He had lymphoma and needed a BMT to save his life. He got lucky and received a transplant of a person who was immune from HIV.
 

Drrrrrr. Celty

Osteo Dullahan
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This is exactly what I was thinking. Very interesting article though for sure.
I remember reading an article saying 11% of Europeans or Eastern Europeans possess this trait. It had something to do with better survival rates with during the Black plague.
 

elftown

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Just had an exam on this today. Interesting stuff.