

HIV appears cured after stem cell transplant - dcurtis
http://www.cnn.com/2009/HEALTH/02/11/health.hiv.stemcell/index.html#

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ntoshev
This story has been on HN before ~3 months (of course it is still news that
the patient is well and without any trace of HIV):

<http://news.ycombinator.com/item?id=357144>

Also see an earlier speculation by a HN reader that such a cure for HIV would
be possible:

<http://news.ycombinator.com/item?id=47746>

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zspade
Yes but FTA: "The case was first reported in November, and the new report is
the first official publication of the case in a medical journal."

This lends a lot more credibility to the news.

------
froo
"It is better to take many small steps in the right direction than to make a
great leap forward only to stumble backward." - Old Chinese Proverb

~~~
akd
Depends on the length and frequency of the steps, the length of the leaps and
stumbles, and the recovery time between a stumble and the next leap.

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spoiledtechie
"About a third of the people die [during such transplants], so it's just too
much of a risk,"

Good Luck

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swombat
From the article, they're extremely unwilling to call even that one successful
patient "cured", as there are other variants of HIV that will latch on to
different receptors.

Sounds like this isn't really big news at all - just one experimental cure
that perhaps appears to have worked for one guy but will probably never be
used in a widespread manner. Or am I too skeptical?

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vinutheraj
That's what I like about this news, they haven't gone over the top with it ..
saying it IS the cure for HIV(though the title is misleading).

The doctor seems cool with saying that it was something experimental that they
did and it seems to have worked, but they still are unsure of it, because the
virus may be hiding.

All in all they have covered it like a proper scientific story.

~~~
Angostura
I came here to say the same thing, it is a _very_ well written story in my
opinion, which manages to be accessible, while at the same time retaining
accuracy. Well done Jacquelyne Froeber and the editors who worked on the copy.

As for whether this is a big deal: Yes - in terms of science, although not
necessarily a big clinical deal. Other strains may use different receptors,
but this is the most common. There is also the mystery question embedded in
the story: Why didn't the other strain he was infected woiith rebound

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niels_olson
I just read the New England Journal report. He wasn't infected with another
strain. Strictly, everyone with HIV is infected with a distribution of strains
because it random mutations happen. The virus can bind either the CCR5
receptor or the CXCR4 receptor. As pressure on the CCR5 pathway increases,
survival of CXCR4-tropic variants becomes more pronounced. Essentially, CCR5
is the easier and more common target of the virus, so the wildtype tends to
equilibrate toward a cluster of strains that favor CCR5. It's simply more
energetically efficient for the virus. It's a thermodynamic equilibrium. In
fact, the report explains this. As HAART therapy is used to suppress the
virus, the surviving viral genes get better and better at binding CXCR4 and it
is a well observed part of the natural course of the disease that
CXCR4-tropism develops late in the course of the disease. The patient lives
longer with HAART therapy, but dies of a slightly different disease than they
were infected with. It's very much the same sort of evolutionary thing that
happens with other, less exotic forms of bacterial antibiotic resistance.

The big deal, intellectually, for me, is the clear-cut experiment that shows
just how dependent on CCR5 the virus really is. Now in my fourth year of
medical school, the professors have always been hedging their statements: well
CCR5 is a known tropic factor, but we really don't know how big a deal it is,
and then there's CXCR4, and maybe there's other factors, so we really don't
know.

Compare that to "took him off HAART and the virus came back like a ton of
bricks. Reapplied HAART and the virus regressed. Coincidentally, we took the
CCR5 receptor site out of his system, then took him off HAART again, and we
get an entirely different response: no virus, and any evidence that there ever
was a virus is slowly fading from his system".

Hopefully there will be other advances in how to kill the HIV, but this very
much a lightswitch sort of event for medicine.

