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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."

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soundoff (118 Responses)
  1. Matt

    First off, I want to make it clear I am not by any means saying this man is "cured" however, I don't believe there is any evidence yet suggesting he is not "cured." This article is entitled "Not the Cure for AIDS" yet lays out no proof that this man still has AIDs. 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. It merely means that there may have been a discovered cure, further testing will verify, and that there needs to be a easier means of replication discovered for this cure. If the man is indeed HIV negative after all advanced forms of testing, there was indeed a cure for AIDs. Disclaimer: I am by no means an expert in AIDs nor a doctor, merely pointing out the argument that "there was no cure found for AIDs thus far has been flawed" I personally fear that even if there is a cure found that as a society we would reject it.

    November 14, 2008 at 19:02 | Report abuse | Reply
  2. Jackson Russell

    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...

    November 14, 2008 at 19:24 | Report abuse | Reply
  3. Leigh

    Thank you for taking the time to clarify this story. While an exciting bit of news, coverage of it completely failed to explain that bone marrow transplant was not a cure or a remote reality for the millions of those living with HIV.

    November 14, 2008 at 19:34 | Report abuse | Reply
  4. Jeanette Dunn

    How would someone find out if they have the HIV resistant mutated gene(s) from both parents, so they would know if their marrow might cure someone of Aids/HIV? What gene(s) are they? Perhaps if people knew theirs was the right kind for this, more people would donate?

    November 14, 2008 at 19:35 | Report abuse | Reply
  5. Bryan

    I would hesitate to blow this case off as a "chance in a milliion" cure for AIDS. This treatment could very well revolutionize the way we treat HIV in the future. To have the potential to cure such a horrible disease is great and exciting. Through gene therapy there may be a way to remove or block the gene that makes people susceptible to HIV. This is just the beginning. I think people who aren't willing to see the future are only blinded by their own ignorance.........

    November 14, 2008 at 19:38 | Report abuse | Reply
  6. JOSH

    Of Course this is no cure, drug companies don't make any money off cures. That is why it's been so long since our precious drug companies have actually been able to cure anything, even the common cold. You only make money with treatments, not cures and so we will never see a cure to cancer or HIV or AIDS

    November 14, 2008 at 19:41 | Report abuse | Reply
  7. Crystal

    That is an awesome finding! Maybe this means that we are a step closer to discovering a cure for HIV/AIDS.

    November 14, 2008 at 19:58 | Report abuse | Reply
  8. Vitus

    As long as researchers and physicians share new developments and continue to sweat for this cause, the cure will be discovered. Remain optimistic that this pandemic will soon be a thing of the past.

    November 14, 2008 at 20:10 | Report abuse | Reply
  9. Saul

    I think peoples obsession with sensationalism really pushed this isolated case out of proportion, like the article mentioned there is so many different outliers that could of potential hinder any real conclusion out of this!
    It's nice to think that there is a cure found but this does not look to be it.

    November 14, 2008 at 20:12 | Report abuse | Reply
  10. Robert

    The number of matching bone marrow donors that are homozygous for the CCR5 mutation is small. However, a person's own bone marrow cells can be treated to artificially create the protective and then be reintroduced into a patients. Site directed zinc-finger nucleases are being developed by companies such as Sangamo which have this capability. Perhaps radiation therapy might not be necessary if someone was implanted with autologous bone marrow stem cells. This however is not a potential cure for the third world but is an important avenue of current research in the HIV/AIDS field.

    November 14, 2008 at 20:32 | Report abuse | Reply
  11. SM

    Thanks for your explanation!! As a medical student, I have been called on to answer this very question for friends.

    November 14, 2008 at 21:11 | Report abuse | Reply
  12. Angry in DC

    Researchers and physician have known about this mutation for twelve years so why is it that they don't know EXACTLY what the gene does to confer immunity to the virus? The answer to that question is that anti-viral medicines cost thousands of dollars a month and are a cash cow for the pharmaceutical companies! This story shows that it is possible to transfer that immunity through bone marrow transplants. That is obviously impractical so find another way!!! They should know everything there is to know about what those genes do and how they modify t-cells or what proteins or enzymes they manufacture. Where are the studies to do gene therapy to splice those genes into those without the mutation? Where are the medicines that use the same mechanisms? NIH does very little pure research anymore. Their current study protocols do nothing more than pass out existing medicines to use patients to teach new doctors and not hard science. I know this because I have been a patient there for more than 15 years. Fauci and the others are so cavalier when they talk about what an amazing virus they are up against. HIV has only 13 genes so it's not that complex. Enough excuses already!

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

    It is a compelling report, and clearly represents an avenue for more research, perhaps even a clinical trial.

    November 14, 2008 at 21:46 | Report abuse | Reply
  14. Raymond

    I would offer this explanation:

    The bone marrow from the donor not only was a match for the genes controlling blood type, but also contained the genes which give rise to HIV resistance. Since blood cells as well as the T-cells differentiate from the same hematapoeitic stem cells, the two are at least fundamentally related in origin. Furthermore, there may be modification genes involved in the T-cell specialization that may draw from this homozygous recessive HIV-resistance, which probably leads to the formation of abnormal (but viable) proteins in the cell wall of the T-cell that would, in wild type genotypes, be used for identification by the HIV retroviral vector. Therefore the vector does not recognize the T-cell as what it is.

    However this may be confounded if the genes for these proteins are instead expressed in the thymus.

    Just offering a slightly technical overview

    November 14, 2008 at 21:49 | Report abuse | Reply
  15. T. Cooper

    I'm appalled at the negative outlooks of AIDS experts and doctors on this wonderful breakthrough no matter how seemingly limited the find is seen to be. The AIDS virus plagues our world and any breakthrough no matter how small it may seem should not be taken lightly, especially one of this caliber: doctors may have cured a man of HIV using a bone marrow transplant from someone with a rare genetic mutation. They say this mutation is limited and has limited practical applications - SO WHAT! Doctors can grow skin, make bone, clone mammals and a variety of other revolutionary scientific techniques not feasible when AIDS was first discovered. With all these advancements doctors and AIDS experts should be more optimistic about this find and not place too much emphasis of the limitations.

    I'm surprised a story about this particular case was not on the front page of every newspaper in the world. It seems to me American AIDS experts and doctors are upset a German doctor beat them to the punch.

    The main point I want to make is this: approach this find, bone marrow transplants of a rare genetic mutation possibly cures AIDS, optimistically not pessimistically.

    T. Cooper, 20

    November 14, 2008 at 21:54 | Report abuse | Reply
  16. Care

    WOW, what a wonderful story. I do wonder why only cacusains have the mutated gene that shows resistance. I hope they continue to look at this case and do more research into it. Who knows maybe we are not that far off from a cure for HIV/AIDS.

    November 14, 2008 at 21:56 | Report abuse | Reply
  17. hank

    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

    What about the rest of the world?

    November 14, 2008 at 21:59 | Report abuse | Reply
  18. Dave Grenier

    The answer to the donor problem is to use the patient's own marrow. Remove some marrow, separate the proper cells, and modify them so that they carry the mutation. Put the marrow, with the genetically modified cells, back into the patient. No need to search for a donor match, no chance of rejection, no need for anti-rejection medication.

    November 14, 2008 at 22:07 | Report abuse | Reply
  19. Gaylen, Pensacola, Florida

    There is more money in the medicine than in the cure. I think god I don't have this disease. I cringe to think that someone out there has a cure but their greed keeps it from those who need it. I doubt you'd ever hear about a cure being found.

    November 14, 2008 at 22:37 | Report abuse | Reply
  20. Daryl

    Falco is right........ I would lean more on his first point, they can test it, still not show but be there. During my travels, I was shocked to learn how many people in countrysides of developing countries do not know about the disease. Hope more feedback comes on this issue , remember dec 1 worlds aids day. Daryl from NYC

    November 14, 2008 at 23:03 | Report abuse | Reply
  21. LJ Requejo

    This needs to be studied, and possibly work on engineering bone marrow that is more resistant to chemotherapy,..then they can attack the AIDS cells more aggressively, and maybe use this in more cases.

    November 14, 2008 at 23:26 | Report abuse | Reply
  22. Emin I.

    Because HIV multiplies in billions everyday in host's body, most probably it can mutate into a strain that successfully may overcome this particular mutation in the host that keeps the virus out of the cells. However, the question is would HIV be able to multiply into that specific strain if the host's genetic mutation prevents the virus' entry into the cells.

    November 15, 2008 at 00:31 | Report abuse | Reply
  23. adam

    I need to add a precision on the subject, the scientists sought did not explain the following: AIDS virus genome integrates infected cells genome and remain forever in the cells 's genome. It can be reactivated after a given time. The article does not say whether retroviral therapy was stopped before testing whether the virus was still there or not, although I have to assume it is the case. By putting the patient through chemotherapy, as the article says, there is a possibility that all infected cells have been destroyed and new uninfected cells develop from the donor and are therefore resistant to AIDS virus infection because of the homozygote resistant gene. That is the reason people called that a cure. There is however another cavea, the fact that bone-marrow transplanted patients are, as the article show, subject to anti-immune drugs to avoid the rejection of the bone marrow transplant. This should favor the reactivation of the virus if there is still some because the patient is defenseless since his immunity is suppressed, but it does not seem to be the case here. There are very sensitive tests that can determine whether the virus is still there or not. Unfortunately, no matter how sensitive the test is, it is extremely difficult to say that the virus is no longer there because one single hidden cell containing the virus is enough to reinfect the whole body should the virus be reactivated. Only time could tell and still. I really believe that this patient, as the German Doctors indicated, should have his case thoroughly investigated. As to Dr.Gallo, I am sorry but he IS NOT one of those that discovered AIDS, those who did so were recently awarded the Noble prize and he was not amongst them. I am not going to get into the huge controversy concerning this point. I really expected the Doctors sought to say that they will be very interested to study this case further and see what they can learn from it, instead of indirectly trying to diminish the importance of the findings. Both Scientists responses was rather disapointing. The truth of the matter is that it is an excellent discovery, that needs to be further studied. A discovery that could be beneficial against many different and specific viral infections and therefore worthy of funding for more work. I wish I could correspond with the scientist who treated this patient.

    November 15, 2008 at 00:42 | Report abuse | Reply
  24. J C Miami

    I have heard of this mutation before. Apparently, it is thought this is a mutation linked to the black plague and why a certain villages survived. I remember reading how many descendants from the villages were tested and a high percentage had this mutation. While not feasible as an application for the entire epidemic, it is indeed exciting. Eventually, one's one cell will be able to be treated to include or emulate this mutation.

    November 15, 2008 at 15:51 | Report abuse | Reply
  25. Louis

    This should be on president Obama's adgenda. The people must make them pour money into and research this! There is a cure.

    November 15, 2008 at 15:52 | Report abuse | Reply
  26. john

    Hi Jackson Russell,

    Disclaimer: I'm no doctor.

    In answer to your idea about cooling, three things...

    1, The virus dies due to low temperatures outside a body. Inside the body, cool temperatures don't kill much. Everything just slows down to a crawl and then, when temp gets low enough, ice crystals form, wreaking all kinds of problems.

    2. If even one virus in a billion survives the lowering of the temperature, you'd still here the claim that low temperatures kill HIV. The practical ramifications of that 1 remaining virus is that it would have some trait that enabled it to survive when all of its counterparts died. The virus would come back, but a much higher percentage of the new viruses would be cold-resistant.

    3. Finally, HIV is a retro-virus. As I understand that, a retro-virus is particularly deadly because it exists as code that produces the actual virus. That means that even if you eradicate the virus, other cells will continue to manufacture it. This separation between the virus and its producer is what confounds immune systems – they're always looking around for the wrong culprit.

    November 15, 2008 at 16:01 | Report abuse | Reply
  27. Andy

    I find it amazing that people seem to think that simply demanding that there be a cure is enough. Would you be willing to try the cure on yourself or a loved one if the testing requirements and research were not done? HIV/AIDS is a serious disease for sure, however look at the strides that have been made so far. Many people are living quite well thanks to the drugs available, and those drugs are making (slowly) their way to the developing world with the help of many dedicated people. I'm not trying to minimize the seriousness of the situation but simply add some perspective.

    November 15, 2008 at 16:02 | Report abuse | Reply
  28. Sean

    Most people are clearly missing the point of the article. A cure is something that can be effectively created and received by those with the disease that will eliminate the presence of the disease vector. It is different from a treatment.

    Furthermore, assuming that this person is cured of AIDS, which I'm totally willing to believe, it would take a LONG LONG time for this sort of thing to be in a 'cure' form. Bone marrow replacements like this are extremely risky, and there are numerous long term consequences. There are plenty of people out there with AIDS but no bone marrow issues for which this sort of bone marrow replacement could lead to even worse health concerns.

    I think that some people are arguing that this opens up a new venue for research, and I totally agree. Scientists agree too. Nothing in this article suggests that scientists are being 'negative' about this 'discovery.' They're being realistic about this specific form of treatment being used as a 'cure' for AIDS. Somewhere down the line, someone might invent a genetic therapy involving a targeted mutation of the 'anti-AIDS' gene. But that's a while from now, and this 'cure' certainly didn't do much to add to the research already being done on the topic.

    November 15, 2008 at 16:03 | Report abuse | Reply
  29. Chris

    This is in response to Matt, although I'm not sure he'll read this. By you saying that this is a cure for HIV is splitting hairs. It's a one time thing. Bone Marrow Transplants result in the death of the patient approximately 10% of the time as a result of the transplant, not counting the underlying diseases. Clorox Bleach will eradicate HIV, but we don't go calling that a cure, because it would also kill the host.

    November 15, 2008 at 16:07 | Report abuse | Reply
  30. Mobius

    No profits in a cure.

    November 15, 2008 at 16:09 | Report abuse | Reply
  31. Joseph

    I see some very intelligent, thoughtful comments along with some very ignorant, pessimistic comments while reading the remarks to this story.

    Firstly, the CCR5-Δ32 mutation has been known to block HIV for DECADES. It was discovered that men in San Francisco in the 1980's who had the CCR5-Δ32 mutation could not be transmitted with HIV, even when 1000 times the amount needed to transmit HIV was transferred into one of their cells. Those of you who think some breakthrough to curing AIDS was JUST discovered in this mutation have a long way to go in terms of your research.

    I strongly suggest that those of you who think something amazing has been found to do your research on the CCR5-Δ32 trait, the genetic variant of CCR5, which HIV uses as a co-receptor to enter its target cells. This entire story revolves around the CCR5-Δ32 mutation, which is ONLY found in a small percentage of Caucasians (and mainly in those of Northern European descent). Learn as much as you can about CCR5-Δ32 before you make presumptuous statements regarding the potential future of transplanting bone marrow to cure AIDS.

    The basis of this article couldn't be more accurate. Those of who who disagree need to re-read it again and again and then do your research in regard to the aspects you aren't completely familiar with.

    And to the pseudo-intellectual "Adam" in the most recent post, much of what you say is incoherent and inaccurate, but most noteworthy is that you remarked that Dr. Gallo didn't discover "AIDS" and that those who "discovered AIDS" won the "Nobel Prize". This article never said that Dr. Gallo discovered AIDS but that he discovered HIV, and there are dozens of doctors credited to both the discovery of HIV and the discovery of AIDS. Those who won the Nobel Prize were simply more fortunate in what patients they came across.

    November 15, 2008 at 16:27 | Report abuse | Reply
  32. Vignesh

    Um, I think people need to remember something. Saying "just mutate the patients own blood" is not something that is really viable here. Really I am not a medical expert. But I know these things are a lot harder then they seem to be when reading them. There isn't a "switch" that you hit on a panel to put mutations in (and not to mention you get crazy complications with mutated blood and stuff like that. If you mess up, suddenly everything goes wrong).

    November 15, 2008 at 16:27 | Report abuse | Reply
  33. Michael J

    I could imagine turning this into a more widely used cure with the addition of stem cell technology. Take some random somatic cells from a person. Alter the genes to include the beneficial mutation. Use nuclear transplant to generate new stem cells. Induce the stem cells to become bone marrow, and transplant. This should erase the need to find a donor with the mutation and greatly reduce the chance of rejection. Years away and then only available to the rich at first, but still a cure.

    November 15, 2008 at 16:39 | Report abuse | Reply
  34. Marc

    In response to the comment from Leigh (Nov 14th) which notes that the article does not explain why bone marrow transplant (BMT) would not be a "realistic" cure for AIDS....there are several answers. First, bone marrow transplantation (BMT) is very expensive therapy that is only available at certain healthcare facilities (i.e. you cant show up to your local hostpial and expect to get a BMT). Second, and probably much more importantly, there are many serious side effects that result from BMT therapy, as evidenced by the fact that it is typically used as second line therpay after a cancer patient has experience a cancer relapse or has not resonded to first line therapy. If BMT therapy were to be "scaled-up" to the level that would be required to treat millions of infected people, there would likey be thousands of individuals who would experience BMT-related morbidity and mortality (ie death). In light of the fact that people with HIV can live long lives with appropriate anti-viral therpay, applicability of any potential cure would require, at least in part, the probablilty of offering minimal treatment-related risk.

    November 15, 2008 at 16:55 | Report abuse | Reply
  35. Mike

    You commenters heaping outrage on drug companies don't understand.

    They do know exactly how this mutation fights off AIDs, it prevents the Virus particles from recognizing cells that it can infect and then injecting itself.

    The problem is that, BMT is not only expensive but it often kills people. You people screaming about money.... those 'greedy' people in the medical profession, if they thought like you claim to do, would proift more handesomely off BMTs for every AIDS patient then current drugs.

    Gene therapy, some day, should be able to create this mutation in host cells. But this will not cure AIDs, because all the cells previously infected will still be infected. But at this point gene therapy is a long ways off and very unsafe.

    November 15, 2008 at 17:06 | Report abuse | Reply
  36. Roger

    It's always frustrating to hear uninformed and conspiracy theorists try to blame the drug companies for not finding a cure for anything. The most obvious way to negate this is to point out vaccines. If some of you thinking you were smart and "on to" drug companies and used a little common sense you would see that no one is out there intentionally prolonging an illness, and even if you want to talk dollars selling a cure is better than giving nothing, or letting another company sell their antiretrovirals. If the cold is so easy too, why don't you get find a cure for it.

    November 15, 2008 at 17:09 | Report abuse | Reply
  37. Ken

    I wonder if it would be possible to clone the resistant bone marrow with stem cells?

    November 15, 2008 at 17:10 | Report abuse | Reply
  38. Becky Turton

    Even if this is an isolated case, so what! Yes, there are a small percentage of Europeans and North Americans (with European descent) who are homozygous for the delta 32 deletion. At least this case offers hope, and some hope of a cure, surely some hope is better than no hope. Would it not be a good idea to ask people to go for genetic testing to find out if they are homozyygous for the delta 32 deletion? If there is a way that we can help save peoples lives, then I say let's go for it, even if it is a long shot.

    November 15, 2008 at 17:12 | Report abuse | Reply
  39. Jon

    Considering the implications, shouldn't the "more sophisticated tests" be done ASAP? Has the patient in question refused this? I assume someone wants to dig deeper into this.

    November 15, 2008 at 17:18 | Report abuse | Reply
  40. John Doe

    Although it would not be possible to find many marrow donors that have the specific genetic material as this person received, it might be possible to develop this marrow through adult stem cells (adult stem cells come from one's own body, not embryos, so it elimates ethical problems). Instead of just brishing this case a simply "farce", we should investigate it further and hold great hope that this is the right pathway to a cure. Sometimes a outside thinking doctor and some simple luck can produce a cure. I do not believe this approach has been used before, but it is a case like this can change our direction on AIDS/HIV that can lead us in the right direction. I pray this may lead us to a cure to eliminate this horrible disease.

    thanks,
    Jon
    Minnesota

    November 15, 2008 at 17:25 | Report abuse | Reply
  41. Cpt. Kangaroo

    The virus integrates itself into the human genome. Everything has to be perfect in order to kill the virus while saving a human being during a transplant. Not a single infected T-cell or macrophage can survive. This individual was lucky.

    As was said previously, marrow transplants are a risky procedure with 20% of individuals dying during the process. You're still talking about 6.6 million people or more that will die. The numbers will be far greater in third world countries.

    Not a cure by any means, but it does look hopeful in terms of another possibility in the future.

    November 15, 2008 at 17:39 | Report abuse | Reply
  42. Alexander Salazar, M.D.

    Criticize all you want, but this is hopefully a step towards curing rather than treating symptoms of HIV.

    November 15, 2008 at 17:39 | Report abuse | Reply
  43. Marcus from Dallas

    What people need to also realize about the 1% who's immune system HIV cannot attack is that they STILL CAN BE carriers of the virus, they just will not develop AIDS. That means they still can carry and infect other people.

    November 15, 2008 at 17:43 | Report abuse | Reply
  44. beck

    I guess I would have to stress that bone marrow transplants (BMT) would have to be the absolute last resort for people with AIDS. I have had the unfortunate experience to have been in a BMT unit for quite some time while supporting a friend and not only are they horrible to go through, but many, many people do not survive them. IF a virus/bacteria/fungus does not kill you while your immune system is gone/weakened, and IF your new bone marrow actually starts producing and IF your old cells don't come back with a vengeance and IF you survive "acute" graft vs. host disease (most often in the skin or gut, in which your intestines kind of slough off from the inside.... its a nightmare) and IF you don't get "chronic" graft-vs. host disease and IF your new immune system thrives enough that you can fight off viruses that attack years later.... then you might be OK. The BMT doctor explained all this to my friends saying, "If you are not crying with fear by the end of this talk, then I haven't explained a bone marrow transplant well enough." It is survivable... but make no mistake... it is a beast.

    November 15, 2008 at 17:47 | Report abuse | Reply
  45. Rob

    "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? "

    While it could possibly kill off the virus it wouldn't kill off the virus' "offspring." I don't know if they have tried this but I do know that a virus replicates itself by injecting its nucleic acid (DNA/RNA) into a host cell. While this nucleic acid begins to mature it is maturing inside the cell until eventually the cell bursts open releasing multiple viruses. So, while hypothermia may work (again I have no idea if this has been tried) it wouldn't kill off the human's own cells that are harboring the maturing virus.

    November 15, 2008 at 18:16 | Report abuse | Reply
  46. Chuck

    Of interest is the frequency quoted for the prevalence of the CCR5 mutation in Caucasian populations and its complete lack in other populations. One other organism also uses the CCR5 receptor for entry and that is Yesrsinia pestis aka the plague. A speculative paper published some time ago put forth the theory that natural selection during the Black Plague and subsequent plagues drove the selection of this mutation.

    One (of many) potential difficulties with pursuing this avenue is the fact that there is actually another co-receptor which is used by some subtypes of HIV, CXCR4, and this subtype is often found in later stage AIDS patients. So a blockade of CCR5, whether by drugs or by marrow transplant, may not provide complete immunity.

    Nevertheless, this is an interesting finding and one that deserves further study, even though the immediate applications may not be apparent at this time.

    November 15, 2008 at 18:30 | Report abuse | Reply
  47. Shadi Beidas

    While very promising to future research, this method is unfortunately not adaptable in large scale treatment. This man was very lucky in that the normal number of compatible donors is 1-5 people. They found 80. This guy already had 16 to 80 times better probability of marrow transplant compatibility than the average person. Many people can't even find a compatible marrow donor.

    November 15, 2008 at 18:33 | Report abuse | Reply
  48. Thomas S. - Honolulu

    Never in my 26 years living “healthy,” with HIV has there been as much advancement in education, research and phenomenal medical data regarding this disease. Those of us who obviously are well aware of the daily mutating and challenging remarkable discovery’s; welcome this news, this is what so many with HIV/AIDS living and sadly past have waited for all these years, “Medical advancements in AIDS is moving forward,” for this we can be assured our voices have been heard, that funding, donations to assist within to the scientific community around the world are being used to find the imperative “answers and discoveries,” while not spending their weekends at luxury spa resorts. I personally thank you for your years of dedication to your work and discoveries; one day millions will be able to rest peacefully knowing it’s over; as was polio at this rate.

    November 15, 2008 at 18:35 | Report abuse | Reply
  49. James

    One snag in this procedure that appeared in other reporting: the patient was given a 20% chance of dying from the pre-operation treatment to suppress his immune system so that the transplant could succeed. Even if cost were not an issue, having one in five patients die during treatment is a risk doctors would not want to take for patients that are not in imminent danger. The importance of this discovery is not that one man many have been cured (only time and observation will confirm that) but that it opens new avenues for research, a point that has been marginalized in much of the media coverage.

    November 15, 2008 at 18:35 | Report abuse | Reply
  50. Scott

    I believe that pharmaceutical companies reap vast rewards from treatment, vice the production of cures for a number of diseases – as some folks have already written. I've also read that cures for some incredibly rare diseases do exist, but because the "demand" for these treatments is so miniscule, the cure is rendered too expensive for anyone, including the pharmaceutical companies, to afford. Some people believe that socialized medicine will cure this issue in and of itself. To that, I ask that the folks of this mindset review previously reported stories regarding Walter Reed Hospital. As a Veteran, myself, I'm here to tell you that Walter Reed is only one drop in a very full bucket. Socialized medicine has always existed in the military, and though it's an obvious necessity in such a venue, overall, it doesn't work very well at all. Nor does it create the wealth that is required to develop cures for many "cure-resistant" diseases. Secondly, though the individual in this report may indeed soon be heralded as the ice-breaker for a new generation of treatment, there is no cure for AIDS. The fact is, AIDS mutates so readily and so consistently that it has rendered most previous forms of treatment obsolete within a very short period of time. One day, a viable cure may be found. In the meantime, taking a little care of yourselves (and curbing risky behavior) shall remain the best "cure" of all – and for us all.

    November 15, 2008 at 18:54 | Report abuse | Reply
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