Aids breakthrough reported!
An American man being treated in Berlin who suffered from AIDS appears to have been cured of the immune disease 20 months after receiving a targeted bone marrow transplant normally used to fight leukemia, according to his doctors.
The physicians and researchers involved are cautioning that this astonishing case may be no more than a fluke. Advocates of gene therapy say this is a prime example of why gene research is so important. AIDS claims approximately 2 million lives each year and the virus has infected 33 million people worldwide.
The patients’ physician Dr. Gero Huetter has reported that his 42-year-old patient on Wednesday, the patient who remains anonymous, claims to have been infected with the AIDS virus for more than a decade. However after 20 months after undergoing a transplant of genetically selected bone marrow, the patient no longer shows signs of carrying the virus.
“We waited every day for a bad reading,” say Dr. Huetter.
It has not come. Researchers at Berlin’s Charite hospital and medical school say tests on the patient’s bone marrow, blood and other organ tissues have all shown no sign of the AIDS virus.
Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., is being quoted that the tests made by the German physicians have probably not been extensive enough.
“A lot more scrutiny from a lot of different biological samples would be required to say it’s not present,” Dr. Badley
This isn’t the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported.
Dr. Huetter’s patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV.
Dr. Huetter – who is a hematologist, not an HIV specialist – prepared to treat the patient’s leukemia with a bone marrow transplant, says that some people carry a genetic mutation that seems to make them resistant to HIV infection.
If the mutation, “Delta 32”, is inherited from both parents, it prevents HIV from attaching itself to cells by blocking CCR5, a receptor that acts as a kind of gateway.
“I read it in 1996, coincidentally,” Dr. Huetter told reporters while I was still a medical student. “I remembered it and thought it might work.”
According to the latest statistics one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient’s marrow type. Out of 80 suitable donors, the 61st person tested positively for the “Delta 32” mutation.
The bone marrow transplant was preceded by a therapy of powerful drugs and radiation designed to kill off his own infected bone marrow cells and disable his immune system – a treatment fatal to between 20 and 30 percent of recipients.
The patient was also taken off the potent drugs used to treat his AIDS. Dr. Huetter’s and his medical team feared that the drug therapy might interfere with the new marrow cells’ survival. They risked lowering his defenses in the hopes that the new, mutated cells would reject the virus on their own.
Anthony Fauci, director of the National Institute of Allergy and Infections Diseases in the U.S., in an interview with AP the procedure was too costly and too dangerous to employ as a firstline cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV.
“It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate,” according to Dr. Fauci.
David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, said gene therapy as cheap and effective as current drug treatments is in very early stages of development.
“That’s a long way down the line because there may be other negative things that go with that mutation that we don’t know about.”
Even for the patient in Berlin, the lack of a clear understanding of exactly why his AIDS has disappeared means his future is far from certain.
“The virus is wily,” Dr. Huetter said. “There could always be a resurgence.”