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November 14th, 2008
05:59 PM ET

Not the cure for AIDS

By Miriam Falco
CNN Medical Managing Editor

A German hospital announced this week that a 42-year old American living in Berlin who did not want to be identified had come to them three years ago for treatment. It was determined that he had acute leukemia (blood cancer) and was HIV positive too.

After a bone marrow transplant, it appears that not only did the man’s cancer go away, so did the virus that causes AIDS.  This has been reported worldwide as a "cure" for AIDS. But even the doctors involved in this case say they don't know if they cured this man of HIV.  So what's all the fuss about? Should HIV patients be treated with a bone marrow transplant?

One of America’s top AIDS expert doesn’t think so. "This is interesting but not a practical application. It's not feasible and has extraordinarily limited practical application" long-time AIDS researcher and Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci told CNN.  He and other researchers first learned of this case back in February. But this study of one patient has not yet been published or been reviewed by other AIDS experts. It didn't get much attention back then because of the many limitations it has.  Dr. Robert Gallo is one of the scientists who discovered HIV. "While this procedure might help a very small minority of people living with AIDS,” Gallo says, “it is by no means the answer to the world's HIV/AIDS pandemic."

Doctors first began treating the cancer with chemotherapy. They also gave him anti-retrovirals to contain the virus that causes AIDS. Doctors said at a press conference this week that the patient did go into remission, but eventually the cancer came back. The next step to treat the cancer was a bone marrow transplant, which is common for leukemia patients.

His doctors emphasized that without further treatment, without the bone marrow transplant, he would have died of cancer – not HIV or AIDS.

But the patient’s physician, Dr. Gero Huetter, wanted to combine the cancer treatment with something he had heard about in medical school 12 years ago. That’s when researchers found out that a certain genetic mutation prevents the virus from getting into a person’s cells. But to be resistant to HIV, one has to have inherited this mutation from both parents.

So when it came to looking for a bone marrow donor for his patient, Huetter decided to see if he could find a donor that not only was a marrow match for his patient, but one who also had these two copies of the genetic mutation to see if they would get the bonus of treating the HIV, while treating the more urgent need – cancer.

Here's where the German doctors admit they were very lucky. They told reporters they normally find one to five qualified donors for their patients in need of a transplant. In this case they found 80 donors. So they systematically tested each donor for the mutation and when they came to the 61st potential donor they hit the jackpot. Nearly two years after the bone marrow transplant, the patient is still in remission from his cancer and he doesn't seem to have any detectable HIV either.

This is probably why many newspaper headlines interpreted the success as being a cure.

However there are many caveats to this story.

1. Even though their tests do not show a presence of HIV in his system, doesn't mean it's not there. This virus is known for hiding well and popping up later. It's been seen before in patients taking anti-retroviral drugs. It is possible that if more sophisticated tests were used on this patient, they would detect the virus that is still in his body. So it's still not entirely clear that he is HIV-free.

2. The chances of finding a bone marrow donor with two copies of this genetic mutation for everyone one of the 33 million people worldwide living with HIV or AIDS is not realistic because only one percent of Caucasians and zero percent of African Americans or Asians have this particular genetic mutation.

3. Bone marrow transplants are dangerous for patients. Before they can get the donated stem cells that will replace their own, they have to take strong chemotherapy to destroy their own bone marrow - leaving them without an immune system to fight off any disease - until the transplanted bone marrow can make new blood cells. Plus patients run the risk of rejecting the new cells, which means they have to take immune-suppressing drugs for the rest of their life.

4. Bone marrow transplants are very expensive and not an option for many people living with this disease around the world.

Both the doctors in Berlin and AIDS experts we've spoken with say this is a "proof of principle." "It's an interesting case for researchers," according to Dr. Rudolf Tauber, from the Charite hospital in Berlin, where the patient was treated. The hope is that this one case could lead to future treatments. Dr. Gallo says, "If patients living with HIV and AIDS have access and can adhere to today's retroviral therapy, many will live longer, healthier lives, perhaps full length lives."

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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soundoff (97 Responses)
  1. martin

    It is interesting that they had to zap his immune system with chemo prior to the marrow transplant, and HIV lives and hides in immune cells.

    Is it possible that the result may not have been solely due to the marrow transplant?

    November 15, 2008 at 19:07 | Report abuse | Reply
  2. Josh

    Thank you for the interesting artircle. We just covered HIV in medical school and unfortunately this case was only mentioned briefly in our lectures.

    As mentioned in the article, this virus can hide very well and may reactivate, but even if this treatment is not successful, it is another step in the right direction.

    November 15, 2008 at 19:08 | Report abuse | Reply
  3. Joel

    Angry in DC (and others interested);
    It is known why the Delta32 mutation confers HIV resistance. People with this mutation lack a key coreceptor on their T-Cell surfaces (called CCR5). Without this receptor, the HIV virus cannot get in to the T-Cell, and, if it can't get in, it cannot destroy the immune cell and it cannot replicate. There are actually drugs that block this receptor (Maraviroc and others in clinical trials. Actually, entry inhibition is a hot topic of research (I work in this area). There is another entry inhibitor, Fuzeon, that works quite well but costs (as of 2 years ago) $25,000 per year per patient.
    The problem with this finding and CCR5 inhibitors is that they only prevent viral entry for viruses that use this coreceptor, while there is another coreceptor that some viruses use; CXCR4. Fortunately for those in Europe, North America, and most of Asia, the HIV virus that is circulating uses CCR5. But where HIV/AIDS is most damaging, Africa, many viruses use CXCR4 or both receptors to enter cells. And, given enough pressure, the CCR5 virons can mutate to use R4. Why not figure out how to block CXCR4 then? Well, unlike CCR5, knock-out mice lacking CXCR4 type receptors die very quickly if they make it into life. We would probably be the same and be super-immunocomprimised if CXCR4 was blocked or lacking.
    The "good" news are there are other ways to prevent HIV entry (go wiki HIV entry inhibitors), and, as this patient suggests, if you can keep HIV from getting in to a person's T-cells, the virus will eventually be suppressed.

    November 15, 2008 at 19:49 | Report abuse | Reply
  4. Jim

    Contracting AIDS is preventable, unlike many other diseases.

    November 15, 2008 at 19:56 | Report abuse | Reply
  5. Nasha

    This is one of the best medical reads in a long time.....HIV is wiping out populations..and this generation is dealing with it in GI-NORMOUS numbers...I truly believe there is a cure out there somewhere....to those living with the Virus...stay strong...to those not, try to reach out...K, I'm done:-)

    November 15, 2008 at 19:57 | Report abuse | Reply
  6. Mark

    I think there are cures existing today for many of the cancers and even Aids but the so called people in charge, at the top, are not willing to lose all the money being made on the many sick people dependent on thier daily meds and doctors visits at this time...

    November 15, 2008 at 20:20 | Report abuse | Reply
  7. Dr. Mike

    Some thoughts/clarifications...
    1. The CCR5 gene prevents the virus from entering and infecting cells. Since most of the virus lives within cells and must be within the cell to propagate itself (using reverse transcriptase), blocking out the virus is preventative of infection.

    2. I don't like the "conspiracy theory" that drug companies only look to develop treatments, but not cures. The common cold was noted - the is no treatment for the common cold!!! All the cold medicines you buy in stores are to decrease the symptoms, but do not affect the virus.

    Moreover, a drug company would LOVE to be the one to develop the cure. Not only is there lots of money in the cure, not only would it bring lots publicity and respect for the drug company, but it is the a humane act! Drug companies make most of their money on drugs increasing sexual activity (e.g. viagra/cialis).

    3. Regarding this story... bone marrow transplantation is like trading one disease (i.e. cancer) for another. Life with any organ transplantation requires lifelong adherence to a medical immunosuppressive regimen, morbidity associated with the above, and frequent monitoring for rejection of the transplant as well as the transplanted cells rejecting your body (graft vs. host disease).

    4. Lastly, it is silly to say that this patient would "have died from cancer, not HIV/AIDS if he didn't get the transplant." The HIV virus itself is NOT the direct cause of death in HIV patients. They die because their bodies are overwhelmed by infections and cancers they become susceptible to as a result of an ineffective immune system. Yes - your immune system fights many cancers!

    5. While the story is very interesting, it is impractical as a solution.... you could just as easily say "moving all HIV/AIDS patients to an island cures AIDS" or "banning sexual intercourse and IV drug use is the cure for AIDS." I think we will be stuck with AIDS for many years to come. I hope you take appropriate actions to prevent disease transmission - a practical cure is a long ways off!

    November 15, 2008 at 20:21 | Report abuse | Reply
  8. Ed

    Initially it was thought that Caucasians who are descendants of those individuals surviving the Bubonic plague during the Dark Ages carries the genes for resistance to HIV because these are the same genes that protected the survivors from black plague during the Dark Ages. Now however, it is thought that smallpox served as the selected pressure against which the CCR-5 gene was selected for in the Northern European population.

    November 15, 2008 at 20:31 | Report abuse | Reply
  9. Kenneth Tai

    As a graduate student in the science field, I want to let readers know that millions of dollars in NIH money and external funds are dedicated to AIDS research, more so than research done on study of of other diseases besides heart disease. Please, leave out the corporations–it's always easy to villify a corporation, but they supply jobs and contribute to the economy. It's always very disheartening to hear people talk about how easy it is to look for something, but the big bad corporation prevents this from happening...no. it doesn't work that way. Every year researchers gather and discuss their progress in HIV vaccines, mechanism of pathogenesis etc. There is a giant force working on HIV and no simple cure will be discovered soon. All we can do is understand how we can attack this virus without affecting the host. Trust me, scientists are competitive and critical...if there was something simple out there, it we would have either found it or found some flaw in it.

    November 15, 2008 at 20:34 | Report abuse | Reply
  10. Anna

    I am a scientist who studies HIV at a top tier research university.
    No one is trying to diminish this finding. The reason to word articles carefully in the manner of this one is to make sure people who have this disease do not get unrealistic expectations. This isn't in an attempt to kill anyone's party. People who study this disease work hard every day to bring about change. I would love to find a cure that would work for people of all nations and socioeconomic status, and that is what my lab is working toward.

    You can be a cynic if you want to, but that won't stop me from going to work tomorrow and continuing to do what I have been doing for years, trying to find a cure. And if I find one, you can bet I will publish it and it will be given peer review and it will get out there. I am a decent, hard working person who believes very much in what I do. I am tired of scientists being villified as people who are just out to make money, or who have some weird vested interest in making sure a cure is hidden from the world. Nothing could be farther from the truth.

    November 15, 2008 at 20:42 | Report abuse | Reply
  11. Wafik El-Deiry

    Bone marrow transplants for AIDS patients with cancer were tried nearly 20 years ago at Johns Hopkins and the HIV came back after recovery from the transplant. It could not be eradicated because it hides out and can come back later. I don't know if the work was published because it was not felt to be a success at the time.

    November 15, 2008 at 20:50 | Report abuse | Reply
  12. Jakae

    Matt – I believe what the author means to imply is that this is not a cure for the aids epidemic. You're right in that it does, in fact, appear to be a "cure" in the sense of it will rid an individual of the virus, but– the author is trying to point out this is not a feasible solution for the vast majority of people who have aids...specifically, those who are living in 3rd world countries. I suspect that the author is worried that the media hype-machine will jump on this and proclaim that a cure for aids has been found, and then those who are most suffering from the disease (again, those in 3rd world countries) will be abandoned.

    I hope that made sense...

    November 15, 2008 at 20:51 | Report abuse | Reply
  13. Cliff

    Funny that Gallo is offering his expert vision on this. He is one that profiteered of the AiDS crisis in the 80s with a rush for the isolationtion of the virus. It has always been about money, not helping people.

    Furthermore, it is pretty well known that stem cell therapy can theoretically cure HIV infections which is the core content of Bone Marrow. Now that we can harvest stem cells more efficiently besides gettting them from aborted babies we can genetically teach the immune system to not allow the HIV infection to spread. Now that we have a new president who is coming on who supports Stem Cell research I am very confident that we will be seeing medical revoulution in the next 10 yrs.

    Stem Cell therapy is a bigger than the discovery of Penecillan.

    But Morbius is right... there is no profit in a cure. Sad sad world.

    November 15, 2008 at 21:13 | Report abuse | Reply
  14. TT

    Please understand that doctors are being pessimistic about this “cure” for a reason. The number of variables involved with this type of treatment are truly staggering. The human immune system is incredibly complex. Your body accumulates information on every disease you encounter and then build a “database” of appropriate responses (antibodies and immune cells) to the given infection. It does this by identifying the cells that belong to you (self/host) from any other cells that may enter your body. These cells are created in the bone marrow.

    Simply finding a bone marrow match for a transplant is really amazing. A “normal” transplant requires that the donor organ’s cells (i.e. kidney, lung, liver, etc…) look enough like the host’s cells that the host’s immune system will not identify it and start attack on the new organ.

    A bone marrow transplant is much more complex. It is like taking a bunch of aggressive guard dogs out of their house and putting them in a similar house with a new family that looks similar, but is not exactly the same. You just pray that none of the guard dogs figure out that couch is supposed to be blue, not green. If they do, things go to hell really fast. Why? The donor’s cells must be similar enough to yours that their bone marrow will not start producing antibodies to your cells. If the match is not correct, the donor’s bone marrow will begin producing immune cells to anything it does not recognize. It is called graft vs. host disease and it is the reason why those with transplants are required to take immunosuppressant medications.

    Now, this is just the complexity of a transplant. Imaging adding virus as devious as HIV to this organized chaos. You can see why the doctors treating this patient were a little surprised to see that it worked. Keep in mind that none of the doctors are claiming that this patient was completely cured. The reason why? HIV is retrovirus and can lay dormant for years before raising its ugly head. What is a retrovirus? That means it has the ability to invade your cells and integrate its DNA into your DNA. It literally becomes part of you at the very most basic level. The only way to get rid of the viral DNA is to destroy the host DNA. If you destroy the host DNA, you kill the cell.

    This man is truly blessed and a miracle. I know he will be studied throughout the world and hopefully. I have given a very simplistic explanation about a very, very complex subject. I hope you can see why doctors and researchers may sound pessimistic.

    November 15, 2008 at 21:25 | Report abuse | Reply
  15. Lucky

    To Josh...drug companies have nothing to do with BMT. Also, without them millions more would die from disease. Since 2006, drug companies have spent over 96 billion on research for new compounds.

    Also, for anyone that knows about BMT, the mortality rate is more than 25%. It's not an easy decision to make. The graft versus host disease alone can be brutal.

    Any doctor or institution that would hurry this research along, would be the first one you would sue if things didn't work out.

    November 15, 2008 at 22:05 | Report abuse | Reply
  16. Frank

    I am not sure that chemotherapy would eradicate CD4+ microglia cells infected with HIV.

    November 15, 2008 at 22:24 | Report abuse | Reply
  17. Why

    You all are really tripping if you are so educated, Please go to school and become a scientist or an AIDS expert so that this can finally end.

    Im sure those that suffer with this disease can care less about hearing your opinions. If you're not an expert please stop knocking the ones that are actually trying to discover something.

    And enough on knocking the drug stores; If its something out there that can make a person feel a little better then maybe to that person its worth thousands of dollars!!

    November 15, 2008 at 22:44 | Report abuse | Reply
  18. Jose

    I've heard that the technology of medically inducing a fever kills cancer cells in a person in Germany. Its been around for more than 20 years (I'm not revealing sources because thats inconsequential concerning the bigger picture). So I say are any of these "experts" here in America going to go to Germany and see first hand what it is that the these medical practitioners have discovered, stumbled upon, partially revealed....Whatever!! Or are we supposed to be content that AIDS is still incurable and we're going to see more deaths due to the strangest virus in the history of human kind (down to certain demographics of people being more succeptable than others). Come on guys we've been sending people to the moon for 38-39 years, embarked upon stem cell technology, theres techtonic warfare technology available for the most powerful (richest!) governments and we still can't cure AIDS??? The American Medical Association and all the leading Pharmceutical companies around the globe are full of shatola, no cream or sugar necessary. Oh by the way, did I forget to mention that AIDS is most prominent in Africa, with new (stronger) strains in Asia!? Well thats what I read about Asian strains (years ago). Is that also not true? I obviously don't have alot of faith in American Medicine as you can tell. Show us all something, damn it all!!! Thats why I don't have any faith. Can you blame me.

    November 15, 2008 at 23:06 | Report abuse | Reply
  19. Josh Akron NY

    I read these conspiracy comments with a mix of disgust and mirth. On one hand it is disgusting for people to think (and keep spamming the comment board) that, "oh all drug companies are evil man, they just want money man." However, at the same time it is so funny to think that people believe these things. If there was no money in a cure then why would we have vaccines to prevent pollio, why would we have chemotheropy, and why would we have antibiotics?

    Now on the topic of the article. It is very interesting that this might a way to cure or at least delay the growth and spread of the HIV virus. However, it is obvious that this will never be a reasonable way to stop the aids epidemic.

    -Josh

    November 15, 2008 at 23:09 | Report abuse | Reply
  20. Dan

    The author makes a great point that MANY times people with HIV taking anti-retroviral drugs will later be tested and come up negative for HIV. The problem is that the tests for HIV (and many viruses for that matter) are not yet sensitive enough to detect low, but still threatening, levels of many viruses including HIV.

    This looks like a promising step forward for RESEARCH, but I think the author is correct saying this cannot be considered a cure, especially because it has not undergone true scientific testing yet: it is not even remotely scientifically accurate to call something a cure off of a single case study.

    November 16, 2008 at 00:08 | Report abuse | Reply
  21. David

    A Bone Marrow Transplant is not a practical solution to treat AIDS for many reasons including toxicity. However, this case report is important because it shows that if an infected patient's T-cells can be replaced with T-cells harboring the CCR5-Δ32 mutation, that the HIV virus can be functionally suppressed without anti retroviral drugs. What has not yet been mentioned is that a clinical trial further testing this hypothesis will hopefully be initiated at the U of Pennsylvania by Dr Carl June later this year. He has proposed removing a patient's own T-cells and modifying them with a technology called zinc-finger nucleases. These modified T-cells then become functionally similar to those from individuals with the inheritied the CCR5-Δ32 mutation. The cells can then be infused back into the patient. When this experiment is performed in HIV infected mice, the infused T-cells selectively survive and expand and produce an effective immune response against the HIV virus. This case report certainly supports the rationale for this kind of approach.

    November 16, 2008 at 00:17 | Report abuse | Reply
  22. Avril

    This article inspired me to be a bone marrow donor. Not because I think I can be one of those people who have those rare gens but because I realize I can help someone. I went to the National Bone Marrow Program website and I found out that in order to be a donor I must cover a $52.00 fee. It's a shame that that fee keeps me from being a donor as I'm not able to afford it... I think we should start from there, make bone marrow donations be available to low income people like me. I have friends who have the HIV virus and if I could help them and anyone living with this decease I would.

    November 16, 2008 at 00:35 | Report abuse | Reply
  23. Dan

    I read about this finding earlier this month in another national paper. They reported that in 1989 another cancer patient who was HIV positive also had a bone marrow transplant, which appeared to clear his body of HIV. Unfortunately, the patient died 47 days after the BMT. However, his autopsy showed no sign of HIV in his internal organs, which is one place they are concerned the reservoirs of dormant virus may be hiding. Hopefully we will find a curative treatment based on this new area of research surrounding CCR5.

    November 16, 2008 at 00:37 | Report abuse | Reply
  24. Sherree from MO

    When I first heard news of this "cure," I immediately thought of Dr. Gupta's first point: current tests are only so sensitive. I'm currently pursuing combined medical and graduate degrees (the PhD is in molecular biology), and what I typically hear doctors say around the hospital is that the reason patients go into cancer remission and then relapse is that those cancerous cells are never completely gone, just present at such low levels that we cannot detect them. With regards to the the idea of chilling people to cure HIV, I suspect that it would not work. I did a very quick literature search, and could not find any indication that anyone has shown cold temperatures to negatively impact the virus. On top of that, it is common practice in laboratories to store things (cells, viruses, etc.) at temps from 4 degrees all the way down to -80 degrees–way too cold for human survival. We later thaw these things and continue studying them as if they'd never been frozen, as it seems to have little effect once they're brought back to room or body temperature.

    November 16, 2008 at 00:48 | Report abuse | Reply
  25. Jon

    "Jackson Russell November 14th, 2008 7:24 pm ET

    I remember hearing some time ago that the virus that causes HIV can’t survive below a temperature range that wasn’t very much cooler than body temperature. Wouldn’t cooling a person’s body for a short time to below that virus survival limitation kill it off and render them free of the virus?

    I’m sure inducing hypothermia would be a risky business, but has it even been tried? Has it been determined how cold a human body can be made to be to the core, and still be successfully re-warmed without excessive risk of death or brain/tissue damage? Can a drug be developed that would cool the body through-and-through to a pre-determined temperature that would coorespond to be lower than the survival limit of the virus and still not kill the patient?

    I’ve never heard of any studies along those lines. Has anyone ever pursued it that line of study?

    Thanks…"

    Such tests have been done. The Nazi scientists testing on the people of the holocaust.

    November 16, 2008 at 01:01 | Report abuse | Reply
  26. chris

    Matt, with all do respect, you clearly have no idea what you are talking about. You clearly have no idea how science works. Just because something happened to have worked in one case under certain circumstances does not in any way make this a "cure" for aids. The word "cure" denotes have a treatment which has been shown to work in essentially all cases–it is bulletproof, a real CURE. This is not that at all. You say "Saying that AIDs might be hiding somewhere in this mans body but we have not found it, or saying that this treatment is expensive or risky does not mean there is no cure for AIDs." Yes, it does. It's not like we've stumbled upon an unknown treatment. Scientists have known about CCR5 for a while now. Bone marrow transplants are extremely risky and dangerous, and the odds of finding a match which is ALSO a homozygote for this mutation is unlikely–which makes its application as a TREATMENT dubious, let alone a CURE...if you had actually READ the article you would understand this. Do some reading before you post something foolish like that.

    November 16, 2008 at 03:09 | Report abuse | Reply
  27. Jason - Tampa, FL

    So what if the bone marrow transplant has a 20% chance of killing the patient? AIDS has a 100% chance. This gives hope to people where hope did not exist before. Of course this should be considered an option!

    November 16, 2008 at 04:04 | Report abuse | Reply
  28. Kyle, Tanzania, East Africa

    As an American Registered Nurse working on the front lines of the HIV pandemic in rural Tanzania, this article and the attention it brings to the problem is wonderful news to my ears. Our region lies where highways from Malawi, South Africa, Zimbabwe, and the port city of Dar es Salaam collide. Our estimated HIV rates are estimated at above 15%. I am thankful that there are intelligent and compassionate people all over the world dedicating their lives to alleviating the suffering caused by this horrible virus.

    However, I cringe to read some of the above bloggers saying that all we need to do is dump more money and effort into "curing" this problem. Billions and billions of aid dollars come pouring into this country every day. We have store rooms full of ARV medications and it is thanks to our American tax dollars and the generous donations from Germany and other countries. It is wonderful to see a patient with a CD4 count of 3, soar to 310 after beginning ARVs. Yet, there is so much room for improvement. Billions of dollars are being siphoned into the pockets of federal government leaders, ward officers, and village leaders – relatively very little of it lands in the hands of those who need it the most. It is time governments reduce their "money dumping" into programs and ideas and begin investing them into people getting their hands dirty on the front lines. Also, until we first fix the problem of poverty, we cannot expect young ladies to stop selling their bodies for a few shillings, just so they can survive. Their will be no eradication as long as the question remains, "Do I risk getting HIV and dying in 10 years or avoid the risk of getting HIV and die this month from starvation?"

    November 16, 2008 at 04:43 | Report abuse | Reply
  29. Hilary Gami

    I think this is a positive step in the right direction. it at least gives us some hope for the future of mankind and particularly us in sub-Saharan Africa.i hope the worlds greatest minds will come together and explore more options through this path.

    November 16, 2008 at 05:36 | Report abuse | Reply
  30. Karyn

    I had the chance to know a lovely young lady in Atlanta with AIDS 16 years ago. This woman underwent a bone marrow transplant at one of the best hospitals without much success. When it came time to have a second one, she declined it and then subsequently the drugs that were sustaining her. Why? The bone transplant was so painful, and in her state, she could hardly bear the first one carried out in her hip. Granted, this person had AIDS, not HIV, but at times the "cure" is worse than the option to die. I miss my friend; she never had the chance to live, marry, have children. (Yes, she was a heterosexual female.) I'm glad advances are still being made, and hope that funding continues to fight this horrible disease.

    November 16, 2008 at 14:36 | Report abuse | Reply
  31. kris

    I agree that a bone marrow transplant is not the ideal, but maybe we can use stem cells to and create bone marrow cells that carry the gene that makes cells resistant to HIV along with their histocompability and put them in a person with HIV. I think there is a lot to be learned here that could potentially lead to a cure.

    November 16, 2008 at 19:09 | Report abuse | Reply
  32. matt (Nov 14)

    In response first off, I completely agree with the notion that this either "treatment" or cure, whatever one cares to argue for, is by no means the final verdict. Neither the article nor I suggested that. On the contrary the article explains that this cannot be applied universally and I accept that as fact
    This finding isn't the answer for everyone. But it better be the start of a serious consideration on how to go about discovering the "final verdict" on HIV/AIDS. I believe the path to a cure may have been the major discovery here. I dare the medical community to set a goal for investigating and perfecting this path in the near future, not the upcoming decades. Be it Stem Cell Research or some other means of introducing this “new immune system” giving our body the knowledge on fighting AIDS with its own immune system and using this rare genetic key, perhaps through a cloning mechanism or by engineering ones own cells, this is what we need to investigate. I for one don’t understand the linguistics of these processes, as I am not a doctor.
    In a final conclusion I have this to say about the article. I agree with the notion that AIDS is by no means a mystery solved, or an ailment of the past. I disagree that this "cure" is not applicable for anyone, obviously the patent who is living today can attest to that. . Certainly he can argue that this finding must have some immediate use for others in the stage of experimental therapies, perhaps others with both Leukemia and HIV/AIDS and without the promise of a long future of antiviral drugs; may for those in the more desperate stages of AIDS. These people certainly can argue that this is a fair chance on extending their life, regardless of the risk. Where is the ethics in telling these people: “This is interesting but not a practical application. It’s not feasible..."
    You cannot ignore the fact that it was indeed a cure (thus far) for one man, and possible hundreds if not thousands of others. A man took an experimental treatment in order to live, and he won, an astonishing victory for the world. This is the message the article needed to convey, but instead mitigated any progress made. I cannot end this comment without saying to all who are in a position in the medical field to make a impact on this finding, DO NOT DISMISS IT, IMPROVE IT. We cannot dwell on pessimism surely the light bulb wasn't perfect when it first lit up a room, and that was after hundreds of trials; further more at that time most homes didn't even have electricity; but we don't use candles today, and we will not be using inconstant bulbs tomorrow. Please in further posts argue not what I wrote but that point, where do we go from here after this historic turning point in the fight for that final verdict, the cure EVERYONE has hoped for, the death of AIDS domestically and abroad.

    November 16, 2008 at 20:37 | Report abuse | Reply
  33. Chasity- St. Louis, MO

    I am not sure if this is a "cure" but I do believe that they should test this theory out on another willing HIV patient. I think that automatically claiming that it is NOT a cure is not fair to those who so desperately want a cure. But, we all have to remember, the money is not in the cure...it is in the disease. If doctors cured HIV, they millions of dollars that they make off of treatments and medications would go down.

    November 17, 2008 at 12:38 | Report abuse | Reply
  34. Wafik El-Deiry, M.D.

    I stand corrected. Here is an abstract from 1989 describing the earlier experience of bone marrow transplantation in a patient with lymphoma (Dr. Saral moved to Emory a few years ago and is still there):

    Allogenic bone marrow transplantation (BMT) plus azidothymidine (AZT) in an AIDS patient with non-Hodgkin's lymphoma (NHL).

    Holland HK, Rossi JJ, Donnenberg AD, Zaia JA, Santos GW, Saral R; International Conference on AIDS.

    Int Conf AIDS. 1989 Jun 4-9; 5: 405 (abstract no. W.B.P.319).
    The Johns Hopkins University, Baltimore, MD, USA

    OBJECTIVE: To evaluate the effect of combined modality therapy (AZT plus allogeneic BMT) on HIV-1 infection in a lymphoma patient with AIDS. METHODS: The patient, a 41 yo HIV-1 culture+ man with NHL, received cyclophosphamide and total body irradiation to ablate tumor, bone marrow and marrow derived cells. AZT (5 mg/kg q 4h) was begun 2 wks prior to BMT. Nine days after initiation of ablative therapy he received 4×10(8) nucleated BM cells/kg from his HLA identical sister. At this time AZT was reduced to 1.3 mg/kg q 4h and maintained at that level for the duration of treatment. HIV-1 was monitored by culture and polymerase chain reaction gene amplification (PCR, LTR and ENV, DNA and reverse transcribed RNA). RESULTS: Despite continuous AZT, engraftment was prompt (17 days to neutrophils greater than 500/mm3). Peripheral blood mononuclear cells and BM samples became HIV-1 negative by culture and PCR 32 days after BMT. The patient died of tumor relapse 47 days after BMT. Complete autopsy showed no evidence of HIV-1 by PCR (brain, BM, spleen, tumor, heart, kidney, liver, lung, colon) or culture (brain, BM, lymph node, tumor). CONCLUSIONS: 1) The patient tolerated intensive therapy associated with BMT 2) Prompt engraftment was attained despite AZT therapy 3) PCR and culture data suggest clearance of host cells harboring virus and prevention of infection of repopulating donor cells.

    November 18, 2008 at 10:32 | Report abuse | Reply
  35. Nelly

    I think this is a great achievement in medicine and with a little additional research disastrous diseases such as AIDS and cancer will be cured.
    Nelly

    November 19, 2008 at 11:25 | Report abuse | Reply
  36. cliff

    Read Jacquelyne Froebers article on Health.com. It clears up some confusion on stem cell bone marrow transplants for HIV.Keep up the research.

    February 12, 2009 at 07:32 | Report abuse | Reply
  37. eddie

    2 QUESTIONS:

    1 . Why can't THOSE IN DOUBT just go ahead and clarify the existence of hiv on the man's body using their advanced/sophisticated hiv testing kits and see whether traces of the virus still exist in his body? -and get back to us(instead of the issue lingering on in some seemingly perpetual undetermined state as is presently the case).

    2. Why dont we just embrace stem-cell research as the FUTURE and probably the best shot to finding many cures for the many long-term ailments? -diabetes2,hiv/aids,cancer the list is endless ...(since evidently, much -almost everything is been tried "mainstream" without much promise or even success...its like looking for the cure in the wrong place when we have a better shot that is staring at us in the eye- infact! not doing this means we are delaying the cures and yes at our own life-expense).

    Concluding...though the issue of "life beginning at conception" remains and abounds(on stem-cell research et all) but even the kids who are now being born will bear the same burden we bear today- question is when will we decide to attack these diseases with all we have...coz at the moment "they" are attacking us with all they have and are ahead at it.

    February 24, 2009 at 02:05 | Report abuse | Reply
  38. Christopher

    Matt-

    First of all, we need to be clear about something. HIV is a virus, and AIDS is a condition that results from being infected with the virus. If you can't get your terminology correct, you can't have intelligent discussion about the subject.

    The point of this article is to serve as the voice of reason. Dr. Gupta isn't being an uber pessimist by posting this, he's telling you what the initial reports should've told you. This is not a cure. I might only be a Ph.D. student researching human retroviruses, but even I could have told you this.

    Hope is out there, but it isn't in this case.

    February 27, 2009 at 17:42 | Report abuse | Reply
  39. Lori

    My husband died from complications of a bone marrow transplant. He also had Acute Leukemia (ALL), he did not have AIDS/HIV. To say it is a cure is a hilarious statement. Although my husband died of complications from a transplant, he still really died of ALL. You can put any kind of spin on it you like, but a BMT is NOT the way to 'cure' AIDS. First of all you have to go through all the chemo which can cause cancer later, possible radiation chemo, etc.; then you have a 25% chance of a major organs failing right off the bat from the transplant alone. Then there are the 'side effects'. My husband had Graft VS host disease and then developed all sorts of problems, which eventually led to his death only 6 months after the transplant.

    I think it is wonderful that this worked for this guy, but as most of the doctors said, it is good case for research.

    Matt, I disagree with your feelings about a cure and society rejecting it if it was there... the doctors we had really did want to see a cure, I know that it is hard for them to see people dieing in their care. They feel frustrated and helpless, just like we do.
    thanks for reading.

    February 27, 2009 at 18:14 | Report abuse | Reply
  40. lisa

    We will have a cure in the near future. I know how hard the scientist are working. If you get the HIV virus take you medicines get your hep shots both A and B. If you get it from a boyfriend that was not faithful to you. Remember to be careful and not to get into that situation again and please don't spread it around. You can live a long and healthy life even with the virus. Do not aggrivate the situation by continuing un-safe practices. Remember you will survive and you will pull through. You must have faith in yourself and faith that in your life time we will make a break through and it will happen . We even might be surprised that it might be something very simple that we didn't even think of. What about BMP

    April 29, 2009 at 00:35 | Report abuse | Reply
  41. Davd

    With as much as they know about the HIV, I wonder why is there no cure or vaccine for it? I do believe that drug companies don't want cures so that they can continue to make money, but I don't believe that every single person that would know about them doing that would keep quiet quiet while millions of people are suffering and dying from diseases. If I knew, I wouldn't care if they threatened to fire me, I would go public with it.

    July 22, 2009 at 07:46 | Report abuse | Reply
  42. Thato

    I believe with this type of debates regarding the pandemic, we are not very far from finding a lasting solution. Lets all remain positive and deal more with the psychological approach to the pandemic, in my opinion most people give in to the HIV/AIDS because of their mind set.

    February 9, 2010 at 07:37 | Report abuse | Reply
  43. tom davis

    While seeing this article, I was struck by the hope that this article starts. I am a healthcare worker, I know all the new studies going on. I know the real science going on. I work with patients who have AIDS/HIV everyday. This disease, always replicates itself. It always has a new way of fighting our meds. While we as humans like to hold some hope out for the best, I dont see that happening. I hate to look at someone and tell them that there is hope when there is none. I know that no person dies of AIDS, they die from the complications of AIDS. The best way to deal with AIDS is to stop passing the disease. While most of the mode of passing AIDS is thru unprotected sex, it has been seen in most human body fluid. AIDS is a death sentence. Dont be mislead.

    March 3, 2010 at 21:48 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.