AIDS Cured?

[MahrinSkel]

http://sanfrancisco.cbslocal.com/2011/05/16/apparent-immunity-gene-cures-bay-area-man-of-aids/

They had discovered an "Immunity Gene", people with a particular mutation didn't get AIDS, HIV would start the infection cycle, they'd test positive for a few months, and then it would just go away.  This guy had AIDS since 1995, got a bone marrow stem cell transplant from an immune donor, and now he doesn't have any HIV in his system.  No symptoms of AIDS even though he quit taking the medications when he got the transplant.

--Dave

[Strazos]

Even though I would really like for there to be a cure, I cannot mentally accept the possibility...this year - it's been far too crazy so far to add this to the pile.

Yowza.

[DaZog]

I read the article, and got a surge of good feelings.

Then I read the comments and promptly 

[sinij]

We can finally start fucking like its 60s again?

[Ragnoros]

Science, Fuck Yeah!

[Fordel]

Aren't bone marrow transplants themselves very risky? Like a last resort kind of thing?

[MahrinSkel]

Yeah.  On the other hand, the maintenance treatment for AIDS is not a picnic, and it doesn't work for everyone. 

There's also the little problem of finding donors that are both immune to AIDS and compatible with the patient.  I suspect that much like "Golden Blood" herpes antibody donors, there's going to be a lot of money in it for people with the immunity and a willingness to get huge needles jammed in their hips.

--Dave

[Simond]

Aren't bone marrow transplants themselves very risky? Like a last resort kind of thing?

I suspect the 'fix' will be doing something like an autologous stem cel transplant and tinkering with the genetics of the patient's own bone marrow that way.

[DLRiley]

We will live long enough as a species for AIDS to cure itself was a good bet 

[ghost]

Aren't bone marrow transplants themselves very risky? Like a last resort kind of thing?

They're getting less and less risky as the technique is getting refined.  For many people with HIV it would be a last resort, so it is a reasonable treatment plan.  Unfortunately, testing for and finding willing donors is going to be tough and there are a LOT of people with HIV worldwide.  I doubt this is going to be the silver bullet.  However it might lead to the silver bullet, if they are able to determine what it is that makes these people immune (CCR5 mutation, IIRC) and then put it to use in another way besides bone marrow transplants.

[Lantyssa]

Great news.  This affects too many of my friends.  I hope this leads to good things.

Aren't bone marrow transplants themselves very risky? Like a last resort kind of thing?

Yes.  He also had leukemia.  It won't be the answer for everyone, but if a method is found that works, then it can be refined and alternatives can be explored more easily.

[Sky]

Can't stem cells be cultured?

[Ironwood]

Yay, another miracle cure for rich fuckers.

[Nebu]

Having done my research fellowship on a pediatric bone marrow transplant (BMT) ward, I can say that this is a start and not the answer.  So many things can and do go wrong when you completely ablate someone's WBC counts.  It's nothing that will be used routinely and certainly will do little to help the HIV epidemic in 3rd world countries.

Yay, another miracle cure for rich fuckers.

While this research is a step in the right direction, this comment is pretty much spot on.  I doubt that Magic Johnson will try this anytime soon though.  Too many risks. 

[K9]

As it stands, this is only an anecdote, we are still a long way from a cure sadly.

[Mrbloodworth]

Yeah a marrow transplant isn't exactly a corner street cure.

[ghost]

I guess this will be a politics thread soon.   

[Ironwood]

That certainly wasn't my intention.  I mean, Yay and all, but it's not the shot in the arm we're looking for yet.

But hey, we cured Leprosy.  We cured leprosy for fucks sake.  LEPROSY.

[Morat20]

I'm with the "Yay, we seem to have solid confirmation that there's a path that shit-cans HIV" crowd, rather than the "Bone Marrow Transplants for Everyone!" crowd.

Although I do kinda want to know if I have that particular mutation myself.....

Anyways, I'm sure if they manage to replicate this elsewhere or figure out the exact interactions, that a lot of money will flow towards drugs that will exploit that particular issue (a new treatment that's probably not an anti-viral) and probably another big push on gene therapy, now that they have a target.

Between that and the new flu shots in development (that seem to target a specific, difficult-to-impossible to mutate part of the virus that is shared between ALL strains of flu, including bird flu) medical science is looking up a bit. Now I only have to be terrified of super-bacteria.

[ghost]

That certainly wasn't my intention.  I mean, Yay and all, but it's not the shot in the arm we're looking for yet.

But hey, we cured Leprosy.  We cured leprosy for fucks sake.  LEPROSY.

Yeah, but this really is a big fucking deal, if true.  It shows us what makes these people immune and hopefully we can come up with a cheaper way to treat the remaining folks.

[Nebu]

Yeah, but this really is a big fucking deal, if true.  It shows us what makes these people immune and hopefully we can come up with a cheaper way to treat the remaining folks.

The outcome is exactly what you'd expect.  While that's a wonderful thing as far as progress is concerned, getting an outcome that you expect isn't all that interesting scientifically.  

[ghost]

Yeah, but this really is a big fucking deal, if true.  It shows us what makes these people immune and hopefully we can come up with a cheaper way to treat the remaining folks.

The outcome is exactly what you'd expect.  While that's a wonderful thing as far as progress is concerned, getting an outcome that you expect isn't all that interesting scientifically.  

Is it?  I don't know a lot about the progress of HIV research.  I wasn't aware that they would have expected this to work.  

Edit:  I also understand in the world of medicine that you don't do new things unless they are expected to have a fair chance to work.  But HIV is a different cat. 

[Morat20]

IIRC, the general process was this:

1) They (HIV researchers) were aware that a specific genetic marker seemed to confer some serious resistance, if not outright immunity, to HIV. There wasn't a whole lot of ethical ways to study it, they just had some statistics that indicated this tiny group wasn't getting AIDS like they were (statistically) supposed to.
2) So some HIV researchers were studying it.
3) A guy with HIV got leukemia.
4) When he was undergoing treatment, someone said "Hey, it's a long shot, but if we've got a choice between matches and one of them has that marker, let's pick that one and see what happens. As long as it's as good a match as the others, there's no harm done to his cancer treatment and it'll do nothing, at worse, to his HIV status"
5) They probably had to go through a lot of HIV patients with leukemia before they got to a guy who had a good match to someone with the marker.
6) They gave the guy that bone marrow and sat back to see what his white blood cells would do, and incidentally cured (or at least dealt a savage blow) to his lethal cancer.
7) Apparently, his new white blood cells made from his new bone marrow ate the HIV virus and laughed at it.

So really, there's not a lot of ethical line-dancing here. It was more "the guy needed new marrow and we picked the good match that had the resistance-marker on it".

[ghost]

"Hey, it's a long shot, but if we've got a choice between matches and one of them has that marker, let's pick that one and see what happens. As long as it's as good a match as the others, there's no harm done to his cancer treatment and it'll do nothing, at worse, to his HIV status"

I understand the process behind what happened.  They were talking about the CCR5 mutation when I was in medical school.  I simply wasn't aware that this was a slam dunk guaranteed result like Nebu said.  Maybe it was.  I figured he would know better than me since he's in research.

[Nebu]

I understand the process behind what happened.  They were talking about the CCR5 mutation when I was in medical school.  I simply wasn't aware that this was a slam dunk guaranteed result like Nebu said.  Maybe it was.  I figured he would know better than me since he's in research.

Ok, there's no such thing as a guarantee in medicine.  I apologize for overstating that.  This was an experiment that should have worked given all prior work. 

My point was more that a) this is a good advancement but b) the more interesting result would have been failure of this method.

My apologies for not being clearer.

[ghost]

No problem.  I wasn't trying to yank your chain on this.  I honestly didn't know how much the results were expected. 

[Nebu]

No problem.  I wasn't trying to yank your chain on this.  I honestly didn't know how much the results were expected. 

I think I should stick to chemistry.  I'm much better at the molecular level than I am with all of this immunology and stem cell stuff anyway. 

[ghost]

I'm perfectly comfortable taking my AIDS/HIV course every three years as required by the Texas State Dental Board.   

We had an HIV rotation in med school and it was pretty awful.  It was much more boring than one might imagine. 

[Morat20]

I'm perfectly comfortable taking my AIDS/HIV course every three years as required by the Texas State Dental Board.   

We had an HIV rotation in med school and it was pretty awful.  It was much more boring than one might imagine. 

It's certainly made the tatoo and piercing industries a hell of a lot more safe, though. I was frankly very impressed by the precautions a local piercer took when a friend of mine got one.

The place was a grubby looking little tatoo shop, but the piercing area was chosen and furnished entirely to be easily sterilized, the guy didn't cut corners, and was very safety concerned -- not just with possible contamination, but with recovery and health of my friend -- including a lengthy discussion of whether or not my friend had a silver allergy or was just prone to infections (he thought the latter, but she went with titanium anyways).

A far cry from piercing guns or your friends with a needle and a bottle of rubbing alcohol. :)

[ghost]

The one area that HIV has probably saved the most people is in the co-prevention of Hepatitis B/C for just the reasons you mentioned, Morat.  Universal precautions are a great thing.  Fuck man, in my dad's dental practice back in the '80s they didn't even use gloves.  They didn't sterilize anything.  Holy shit that is disgusting.

[Sky]

I'm much better at the molecular level

No reason to belittle yourself. Nobody is going to put you under a microscope here.

[Morat20]

The one area that HIV has probably saved the most people is in the co-prevention of Hepatitis B/C for just the reasons you mentioned, Morat.  Universal precautions are a great thing.  Fuck man, in my dad's dental practice back in the '80s they didn't even use gloves.  They didn't sterilize anything.  Holy shit that is disgusting.

IIRC, dentists and dental technicians were known for frequently having cold sore breakouts on their fingers. It takes a lot of work to get cold sores on your hands, but ungloved and poking around a mouth is probably the best way to go about, if you do it day in and day out.

Still, what's ironic/sad is you can STILL massively cut hospital infections by posting stuff like handwashing instructions everywhere -- not for visitors, for staff because they either miss, forget, or just skip sanitizing steps. (Probably because they think "Hell, I've got gloves on" and don't really pay too much attention unless there's going to be blood or sharps around)

[ghost]

You know what one of the biggest sources of infection in hospitals is?  Cellphones, particularly the ones the floor nurses carry around with them.  You hit on another great point-  until we can get our hospitals cleaner we're really pissing up a rope with nosocomial infections. 

[K9]

Although I do kinda want to know if I have that particular mutation myself.....

Odds of it being a single point mutation are next to nil I'd say. I'll wait on seeing the actual paper about this before I get too excited. The press has a grave tendency to overhype the notion of "gene for X", "mutation that stops Y", when in reality the explanations are a lot more involved.

But hey, we cured Leprosy.  We cured leprosy for fucks sake.  LEPROSY.

Eradicating smallpox remains one of science's greatest triumphs, and we're almost there with polio.

[Morat20]

Odds of it being a single point mutation are next to nil I'd say. I'll wait on seeing the actual paper about this before I get too excited. The press has a grave tendency to overhype the notion of "gene for X", "mutation that stops Y", when in reality the explanations are a lot more involved.

IIRC, the gene is found in about 1% of Caucasians. I think it's actually a bit bad, insofar as it causes your t-cells or something to be weaker in general, but seems to offer resistance to bubonic plague and smallpox.

Hence why it's floating around in European descendents.

According to wikipedia, they're already testing gene-therapies built on this. Started in 2009.