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Bone marrow transplant cures AIDS?

BERLIN: A bone marrow transplant using stem cells from a donor with natural genetic resistance to the AIDS virus has left an HIV patient free of infection for nearly two years, said German researchers.

The patient, an American living in Berlin, was infected with the human immunodeficiency virus (HIV) that causes AIDS and also had leukaemia.

The best treatment for the leukaemia was a bone marrow transplant, which takes the stem cells from a healthy donor’s immune system to replace the patient’s cancer-ridden cells.

Dr. Gero Hutter and Thomas Schneider of the Clinic for Gastroenterology, Infections and Rheumatology of the Berlin Charite Hospital said on Wednesday the team sought a bone marrow donor who had a genetic mutation known to help the body resist AIDS infection.

The mutation affects a receptor, a cellular doorway, called CCR5 that the HIV uses to get into the cells it infects. When they found a donor with the mutation, they used that bone marrow to treat the patient. Not only did the leukaemia disappear, but so did the HIV.

“As of today, more than 20 months after the successful transplant, no HIV can be detected in the patient,” the clinic said in a statement. “We performed all tests, not only with blood but also with other reservoirs,” said Mr. Schneider, adding: “But we cannot exclude the possibility that it’s still there.”

The researchers stressed this would never become a standard treatment for HIV. Bone marrow stem cell transplants are rigorous and dangerous and require the patient to first have his or her own bone marrow completely destroyed.

Patients risk death from even the most minor infections because they have no immune system until the stem cells can grow and replace their own.

HIV has no cure and is always fatal. Cocktails of drugs can keep the virus suppressed, sometimes to undetectable levels. But research shows the virus never disappears — it lurks in so-called reservoirs throughout the body.

Dr. Hutter’s team said they have been unable to find any trace of the virus in their 42-year-old patient, but that does not mean it is not there. “The virus is tricky. It can always return,” said Dr. Hutter.

The CCR5 mutation is found in about 3 percent of Europeans, said the researchers.

They said the study suggests that gene therapy, a highly experimental technology, might someday be used to help treat patients with HIV.

An increasing number of countries worldwide are making spreading HIV a crime, according to a new report from the International Planned Parenthood Federation. Health officials fear the trend could undermine gains made in fighting the AIDS pandemic and provoke a surge in cases. Globally, about 33 million people are thought to have HIV and nearly 3 million people are newly infected every year.

“If the law is applied badly, this could set us back and do incredible damage,” said Paul de Lay, an AIDS expert at UNAIDS. He said the laws could result in forced testing and drive the epidemic underground as people hide their HIV status, allowing the virus to spread unnoticed. — Agencies

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