findings, saying whatever traces of HIV remained were dead.
The Boston patients
This summer, two anonymous HIV sufferers, known as the ÂBoston patientsÊ, are said to have been cured. The key to their ÂcureÊ is the bone marrow transplants they underwent three and five years ago respectively. Normally, doctors wouldnÊt recommend such a drastic procedure for HIV alone – the treatment carries a 20% risk of death – but both patients had life-threatening lymphomas (a type of blood cancer), complications of their HIV. The bone marrow transplants successfully treated both the cancer and the HIV infection. For years after their transplants, the Boston patients remained on ARVs. But for three and five months now (at the time of writing: half-way through August 2013), they have been off their medications, and the virus remains at bay. 25 Nevertheless, doctors will need to follow the men closely for at least a year, because the virus may be hiding out in latent reservoirs. 26 If the men stay healthy, they will be the third and fourth patients ever to be cured of HIV, after Timothy Ray Brown and the baby in Mississippi. 27 The Boston patients are the most promising development yet on our way to finding the cure for HIV. Researchers and doctors are excited about the news, especially since the Boston patientsÊ treatment differed from that of Brown in one key way – Brown was given stem cells that were predisposed to resist HIV infection due to CCR5- ∆ 32, while the stem cells that the Bostonians received had no such resistance. Their doctors believe that the transplanted cells must therefore have been protected from infection by the antiretroviral drugs taken during cancer treatment. 28 The finding is very important for people with HIV who also need blood-cell transplants, but the treatment is unlikely to 25 [New Scientist, Double good news from HIV front line , 2013] 26 [Nature, Stem-cell transplants may purge HIV , 2013] 27 [Nature, InfantÊs vanquished HIV leaves doctors puzzled , 2013] 28 [Bloomberg, Stem Cell Transplants Clear HIV in Two Patients in Study , 2013]
So, have we found the cure for HIV? Well, the CCR5- ∆ 32 mutation is present only in people of European descent, and then only in 4-16% of these people. 20 Furthermore, donors have to be of the same blood group as the patient. In fact, Hutter repeated the procedure in 2008 with 12 other people who had both HIV and cancer, but some were too sick to undergo treatment, and others couldnÊt find matching donors or ran into other roadblocks. 21 Scientists hope to investigate other avenues for a more reliable remedy. Separately, the International Maternal Paediatric Adolescent AIDS Clinical Trials (IMPAACT) Group is trying to replicate the Berlin patientÊs cure by giving CCR5- ∆ 32- mutated blood from umbilical cords to children with HIV. 22 The trials mark a change for the field: so far, most research worldwide has focused on adults. In 2012, the National Institute of Allergy and Infectious Diseases (NIAID) spent US$18 million on HIV cure research in adults, and just $45,000 on children. Yet 3.3 million children worldwide have HIV. 23 Children have been an afterthought in the fight against HIV, but the immune system of the child might be more easily manipulated to allow a cure. This was highlighted in March 2013, when it was announced that a baby in Mississippi who received treatment for HIV within 31 hours of birth stopped medication at 18 months without the virus rebounding. 24 Paediatric treatment
20 [Wikipedia, CCR5 receptor , 2013] 21 [Huffington Post, Timothy Ray Brown, ÂBerlin PatientÊ, And His Doctor Are Convinced⁄ , 2012] 22 [Nature, InfantÊs vanquished HIV leaves doctors puzzled , 2013] 23 [Nature, Bid to cure HIV ramps up , 2013] 24 [abcNews, Mississippi Baby Born With HIV ÂFunctionally CuredÊ, Doctors Say , 2013]
4
Made with FlippingBook - Online Brochure Maker