Print 12 comment(s) - last by 7Enigma.. on Jul 9 at 11:51 AM

But they're not calling it a cure quite yet

HIV patients have new hope for a cure as two men recently became HIV-free with bone marrow transplants. 

Doctors at the Dana-Farber/Brigham and Women's Cancer Centre in Boston performed bone marrow transplants on two men with HIV, and neither have had to use Aids drugs for extended periods of time since the operations. 

One of the men has had HIV since he was a baby while the other became infected years ago. Both men received bone marrow transplants in Boston, where their cells were replaced by those of the donors. 

Doctors have been checking the men regularly for signs of HIV in both blood cells and tissue, and the virus has fallen to an undetectable level in both men. 

What's more is that one stopped taking antiretroviral medication four months ago while the other quit seven weeks ago. Still no sign of the virus. 

However, Timothy Henrich -- from the division of infectious diseases at Brigham -- said not to celebrate a cure quite yet. While the virus isn't detectable in blood or tissue, it could be hiding in other places like organs and reappear later. 

Even if the virus doesn't reappear, bone marrow transplants are not something to be taken lightly. There is a 15-20 percent mortality rate and patients must take immunosuppressive drugs for the rest of their lives (which prevent the immune system from performing normal duties, such as fighting off infections). 

"While these results are exciting, they do not yet indicate that the men have been cured," said Henrich. "Long-term follow up of at least one year will be required to understand the full impact of a bone marow transplant on HIV persistence."

Nevertheless, this is a great finding that could lead to a better understanding of the virus, better treatments and eventually (hopefully) a cure. 

Source: The Guardian

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Come a long way
By FITCamaro on 7/3/2013 1:56:41 PM , Rating: 3
Bone marrow transplants have come a long way apparently. I thought it was this extremely painful procedure when I first learned my mom would be having one due to leukemia. But she went through it largely pain free and serious side effects free. Apparently now its done with stem cells instead of needing to drill into the donors hip to get the sample. Both extraction and replacement are done through IV.

RE: Come a long way
By MozeeToby on 7/3/2013 2:54:47 PM , Rating: 3
Well, bone marrow the old fasioned way is "stem cells" too, but yes, the new procedures are a lot less painful than the old. Basically, they give the donor a drug (filgrastim) that causes their bone marrow cells to divide like crazy which in turn causes them to leach out of the bones and into the blood stream. Then they can take blood out, spin it in a centrifuge, and separate out the stem cells from the rest. The drug has some side effects, including bone pain, but much less so than drilling into your hip under general anesthesia.

By the sound of it, your mother maybe had the transplant procedure where killing the recipient's bone marrow off isn't necessary? That would explain why she had an easier (in purely relative terms of course) time with it than you might expect. The procedure of killing off the recipient's bone marrow is really quite hair raising... basically giving them a just barely fatal dose of chemo and/or radiation, then waiting for the marrow to die off, then waiting for the new marrow to establish itself (and in the meantime having no white blood cells, no red cell production, no platelet production, etc).

RE: Come a long way
By FITCamaro on 7/4/2013 7:10:12 AM , Rating: 2
No she had chemo to kill hers off. But I guess she handled it pretty well.

RE: Come a long way
By dgingerich on 7/3/2013 4:54:52 PM , Rating: 2
What's even better is that scientists have used belly fat cells to produce stem cells that could then be converted to marrow cells. Eventually, people could actually have they bone marrow replaced with cell that have their own genetic code, removing the need for immunosuppressive drugs, and get a liposuction while they're at it.

RE: Come a long way
By Pudro on 7/5/2013 4:48:20 AM , Rating: 2
That won't work. The HIV is "cured" because the marrow from the donors creates blood that is immune to it (i.e. the donors are already immune). If the marrow had their own code, it would make the same susceptible blood they had before.

RE: Come a long way
By 7Enigma on 7/9/2013 11:47:13 AM , Rating: 2
You have no idea what you are talking about so please just stop. The donor marrow is not "immune" to HIV/AIDS, it just doesn't have the infection. The purpose of a bone marrow transplant is to wipe out your own immune system completely (or as near complete as possible) and then get someone else's marrow (after the waiting period to clear the body of the chemotherapeutics). This is called an allogenic transplant and is common in diseases/conditions where the body has already been compromised. The more attractive transplant type is where you can harvest your own cells ahead of time, then nuke your body, and then put the harvested cells back in. This is much less risky since your body will not reject the transplant, where you can have graft vs. host disease with someone else's marrow. But obviously in this situation that is not feasible.

Also the number's quoted for mortality are artificially high due to the condition most people are in when going through this procedure. They are typically old(er), with several contributing factors that may cause death not associated with the actual transplant. And for the donor's themselves there is VERY little risk of serious complications.

I urge everyone that is not a bone marrow donor ( become one. It's a simple and free procedure where they send you a swab in the mail, you swab your cheek, and then you are in the registry. If you are ever called upon to donate you are not obligated (though I would hope you would), and it may be a young child or young adult that needs help, not just an old person that has lived a long life.

Some cure...
By Visual on 7/4/2013 9:11:12 AM , Rating: 2
... patients must take immunosuppressive drugs for the rest of their lives (which prevent the immune system from performing normal duties, such as fighting off infections) (which is exactly what HIV causes as well)

RE: Some cure...
By Totally on 7/4/2013 12:24:12 PM , Rating: 2
I was thinking the same thing as well, but I just wrote it off as a "choose your poison" kind of deal.

RE: Some cure...
By Lugaidster on 7/5/2013 1:36:26 PM , Rating: 2
On the plus side, they can have unprotected sex and children again without the risk of spreading the disease.

RE: Some cure...
By UberRoy on 7/6/2013 5:23:23 AM , Rating: 2
I was diagnosed with A.L.L leukemia in 2004 and i was 19, I had 6 months of various drugs & chemotherapy and then 6 months of Chemotherapy and radiation therapy to kill off my bone marrow to prepare me for a bone marrow transplant, my brother and sister were both matching bone marrow donors, they went with my brother as the donor, I had the worst reactions to the treatment they had seen.... it was rough, throughout the treatment i had several lumber punctures administer chemo into my spinal column and brain, L.P suck but worse were the bone marrow aspirates where they drill in to your thigh to take marrow samples to see if the treatment is working. My brother was o blood type and I was A, they feed his bone marrow to me through an i.v drip, I now have his bone marrow and took on his blood type as well and lost mine, It still amazes me what medical science can do and the fact that the bone marrow and blood i was born with is none existent anymore.. anyways I'm 100% now & I don't have to be on any drugs at all now. I'm now 28.

RE: Some cure...
By 7Enigma on 7/9/2013 11:51:32 AM , Rating: 2
Congrats man! You are the reason why everyone should become a prospective donor. Everyone typically thinks BMT's are for old people, or people that "deserved" it, but just as likely is a child or young adult that didn't "do" anything to need the transplant that could live a long and fruitful life if given the chance most of us take for granted every day. people. Sign up, become a donor. It's free. You swab your mouth, no biopsies, no pain. Just swab your mouth and mail in the sample.

It's okay. After their....
By overlandpark4me on 7/4/13, Rating: -1
"I f***ing cannot play Halo 2 multiplayer. I cannot do it." -- Bungie Technical Lead Chris Butcher

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