23 ms·

HIV Is Reported Cured in a Second Patient

935 points by aaronbrethorst 8y ago

Kye 8y ago
Caveat: one kind of HIV. >> "This is only going to work if someone has a virus that really only uses CCR5 for entry — and that’s actually probably about 50 percent of the people who are living with H.I.V., if not less"
- burlesona 8y ago
  Yes, but an actual cure for up to half of people with HIV would still be a huge positive.
  - WrtCdEvrydy 8y ago
    Standby for insulin pricing!
    - deleted 8y ago
      [deleted]
    - lojack 8y ago
      Which is completely irrelevant to this because insulin isn’t a cure and has been around for nearly a century.
    - biesnecker 8y ago
      Insulin pricing would still be a lot cheaper than the anti-retrovirals are today I think.
Herodotus38 8y ago
This is using a stem cell transplant again like the first person which carries a high risk of lifelong complications and death. While awesome, this is not a realistic or great option for patients without another issue needing a stem cell transplant. With modern HAART therapy one is expected to live as long as the average non-HIV infected patient in the US.
- fastball 8y ago
  HIV is still transmissible even with HAART therapy, so I'm not sure how it's relevant to the discussion of a cure.
  - woofyman 8y ago
    Undetectable also means non transmissible.
    - toomuchtodo 8y ago
      Bold claim. How recent are HPV tests? Edit: While my comment came from caution due to historical human hubris, it appears I am wrong: “According to the Centers for Disease Control and Prevention (CDC), a person with an undetectable viral load has “effectively no risk” of sexually transmitting HIV. In 2016, the Prevention Access Campaign launched the U=U, or Undetectable = Untransmittable, campaign.”
      - pryce 8y ago
        That claim isn't a bold assessment of the medical literature at all, it's actually widely held to by the medical organizations responsible for HIV treatment and prevention. Here [1] is for instance an article referencing this claim, describing it as "based on strong scientific evidence" that was peer reviewed published by the journal of the American Medical Association. (EDIT: it's important to add the caveat, which is that this claim is about sexual transmission only, and does not cover pregnant-mother-to-child transmission or intravenous needle sharing). Also your comment now refers to "HPV" which is the name of a different disease. [1] https://jamanetwork.com/journals/jama/article-abstract/2720997 https://jamanetwork.com/journals/jama/article-abstract/27209...
        toomuchtodo 8y ago
        I refer to HPV as a case study in humans not having tests available for a communicable disease (no HPV test exists for men) and underestimating it’s communicability (not to mention it’s role in causing several types of cancer). Apologies if you thought I was confusing HPV and HIV. Too often we think we’re smarter than we are, and the consequences can be damning. Hence why I said its a bold claim that undetectable means it can’t be transmitted. Are we absolutely sure? Because if we’re not, someone could acquire a life long chronic disease that would otherwise have been preventable. But the CDC says undetectable says no transmission; I hope they’re right in 100% of transmission scenarios.
temporalparts 8y ago
> But rearming the body with immune cells similarly modified to resist H.I.V. might well succeed as a practical treatment, experts said. Do people know what is the existing literature on injecting or transplanting different or modified immune cells into someone as a general class of cures? Seems like this could generalize into something of an alternative to vaccine (or a different class of cures).
- zaroth 8y ago
  There’s a massive arm of cancer research devoted to exactly this, called immunotherapy. It’s where many of the best new treatments are being discovered lately. People are calling it the new chemo. It’s particular promising in leukemia, for example. Typically involves injecting a growth factor and then harvesting stem cells from peripheral blood (as supposed to having to go into the marrow directly), then processing the cells in some way to make them more antagonistic to the cancerous mutations. In some cases the cancerous cells will be tagged with some marker that can then be used as a target site the extracted cells can be trained on. Then the patient’s own stem-cells are transplanted back into their body to do their work. Sometimes the patient gets ablated before reintoducing the new cells. That’s called an autologous (“auto”) stem-cell transplant.
xfitm3 8y ago
While this treatment course doesn't appear to be without serious side effects or scale well let's not lose sight of the real win here. Reinforcing that a cure is possible. "The surprise success now confirms that a cure for H.I.V. infection is possible, if difficult, researchers said."
- ddebernardy 8y ago
  ^ So much this. For everyone of us who know and care about someone who has HIV, and for everyone who has it, it's basically a sunbeam of hope -- regardless of how effective or not it turns out to be in practice.
  - gregimba 8y ago
    Especially people who both parents died of age like my siblings. It gives you hope for a future where that won't be the outcome.
pgrote 8y ago
The existing research of the berlin patient (https://en.wikipedia.org/wiki/Timothy_Ray_Brown https://en.wikipedia.org/wiki/Timothy_Ray_Brown) indicates the likely elimination of HIV was graft vs. host disease (https://en.wikipedia.org/wiki/Graft-versus-host_disease#HIV_elimination https://en.wikipedia.org/wiki/Graft-versus-host_disease#HIV_...). The NY Times doesn't mention graft vs. host, but the doctor treating the berlin patient says no one else was cured undergoing the treatment the berlin patient underwent. According to records, 6 additional people were thought to be cured. I couldn't find any follow-up on them. (https://www.newscientist.com/article/mg23431244-400-immune-war-with-donor-cells-after-transplant-may-wipe-out-hiv/ https://www.newscientist.com/article/mg23431244-400-immune-w...)
- h3throw 8y ago
  Feels a bit like correlation vs causation. It's unclear what the mechanism of action in GvH would be and it's also clear in this case that GvH was not necessary.
- rincebrain 8y ago
  [1] suggests this was also true here, but AFAICT the other patients they've tried this on to see if it was just graft versus host all wound up relapsing (I swear there was another study of this negative outcome with n>2, but I'm not turning it up, so maybe I'm full of it). [2] Though [3] claims another set of experiments with this resulted in 5 cured/undetectable patients and one remission who was allegedly an odd duck out in terms of treatment (cord blood versus bone marrow), [1] - https://www.theguardian.com/society/2019/mar/05/london-patient-becomes-second-man-to-be-cleared-of-aids-virus https://www.theguardian.com/society/2019/mar/05/london-patie... [2] - https://www.nature.com/news/hopes-of-hiv-cure-in-boston-patients-dashed-1.14324 https://www.nature.com/news/hopes-of-hiv-cure-in-boston-pati... [3] - https://annals.org/aim/article-abstract/2707334/mechanisms-contribute-profound-reduction-hiv-1-reservoir-after-allogeneic-stem https://annals.org/aim/article-abstract/2707334/mechanisms-c...
rayiner 8y ago
As a kid who grew up in the 1990s, I consider this the biggest technological advance in my lifetime. HIV was a death sentence back then. Arthur Ashe died of it in 1992, and Magic Johnson announced he had it in 1991. It was in our minds right up there with global warming and the hole in the ozone layer as a existential threat to humanity. And now... a 20-something who begins antiretroviral therapy today can expect to live into his or her late 70s. It's a scientific miracle.
- newsbinator 8y ago
  As a fellow 90's kid who read almost every book Isaac Asimov wrote, I was shocked to learn he died in 1992 from AIDS acquired previously from a blood transfusion. The sooner humanity can mostly forget that HIV/AIDS was ever a thing, the better.
  - rrishi 8y ago
    I am a huge fan of Asimov too. I didn't know he died of AIDS. That's unfortunate.
    - phlakaton 8y ago
      He and his family kept that fact private, I understand, until years after his passing, because of the enormous stigma around it. That stigma remains one of the most tragic consequences of the disease, as Randy Shilts so devastatingly documented.
  - v1vek 8y ago
    I have read most, but not all of his work but did't know that's how he died. I wasn't old enough in the 90s to understand HIV/AIDS completely but remember it being a death sentence (I remember a rumor that you could get it by using public toilets)
    - billfruit 8y ago
      Reportedly his family didn't publicize the matter at the time, due to the prejudice it would have triggered. His auto biography also does not mention it. It was only made public by his family, several years after his death.
ausbah 8y ago
Personally, I wish what would really get attention in the realm of HIV treatments is invention and subsequent spread of "prevention" drugs like PrEP (significantly lowering chances of getting HIV if taken daily) and PEP ("fight off" HIV if possibly exposed to it in the last 72 hours), in addition to amazingly high level of quality that HIV therapies have reached such that if HIV can't be detected - its effectively untransmittable. Not trying to draw attention away from the potential significance of the article, would just like more of the "widespread", effective treatments get a little light.
- joshlittle 8y ago
  Not gonna disagree; the treatments are good and getting better for PLWHs - side effects are nearly nonexistent on the day to day and better than they were in the long run. And PrEP / nPEP are miracles at reducing seroconversions in high risk groups/persons exposed. We do need a cure. The damage done to the body of an HIV positive person who’s undetectable, on HAART/meds is progressive, permanent, and irreversible. Even on treatment, chronic inflammation of the immune system adds a lot of undue stress to the body. While I’m not at risk for any AIDS defining illnesses/cancers, I’ve still got a very high risk of other cancers compared to someone who’s HIV-negative. I’m grateful for laws protecting people like me with pre existing conditions - which forces my insurance company to fully cover my $6000 US/mo in HAART treatment. (Symtuza/Tivicay if curious) What’s the amount of money big pharma will make over the course of my life alone? Millions if they can keep this up. How great could life be without HIV in it for good? I’d like to find out, or at least maybe get my doctor to stop asking me to fill out an advanced care directive. I’m thankful otherwise that at 32 I’m fit, in perfect health, and undetectable. Someday I hope i’ll change my status to “cured.”
- torstenvl 8y ago
  I'm on PrEP. It was astoundingly hard to get on. So many primary care doctors have no idea what it is or why to prescribe it.
  - rickycook 8y ago
    in australia at least these days, i’ve gone to arbitrary doctors for my 3mo tests and things and almost always they’ve offered to prescribe me PrEP... i’m already on it, but it seems here it’s being promoted by almost everyone!
canada_dry 8y ago
I assume it's the same method they've successfully used to eliminate Multiple Sclerosis. https://www.bbc.com/news/health-43435868 https://www.bbc.com/news/health-43435868 How are we not pumping billions more into stem cell research?!?
- deleted 8y ago
  [deleted]
- save_ferris 8y ago
  Perhaps because it's controversial on religious grounds. W. vetoed multiple embryonic stem cell research bills during his administration, the Catholic Church still formally opposes it[0], as well as the Southern Baptist Convention. [0]: http://www.usccb.org/issues-and-action/human-life-and-dignity/stem-cell-research/index.cfm http://www.usccb.org/issues-and-action/human-life-and-dignit...
  - toomuchtodo 8y ago
    My understanding is that embryonic stem cells are no longer needed for today’s stem cell research. If a domain expert sees this, call me out if I’m wrong. https://www.scientificamerican.com/article/human-stem-cells-no-embryo/ https://www.scientificamerican.com/article/human-stem-cells-... (Human Stem Cell Breakthrough: No Embryos Required, 2007)
  - rayiner 8y ago
    This treatment was actually done with stem cells from an adult donor.[1] (Stem cell research is a bit of a black eye for liberals in my opinion. W. Bush's restrictions on embryonic stem cell research were not particularly draconian. It was limited to use of federal funds, and even then only restricted creating new embryonic stem cell lines. And the left was just wrong on how much could be done with adult stem cells. That is not to say that adult stem cells are an alternative in every case, but rather that a lot of the folks calling Republicans anti-science were themselves wrong on the science of how promising adult stem cell research was.) [1] I'll also add: the question of whether destroying embryos for research is moral is not a religious one, but rather a political issue on which religions have strong opinions. So long as the government makes it illegal to kill people, it must as a purely political question define what a "person" is and what the exceptions are to that rule. Thus, the death penalty is a political issue rather than a religious issue, even though e.g. the Catholic church and several protestant denominations officially condemn it.
bcks 8y ago
Related: whatever happened to The Immunity Project, the AIDS vaccine funded by Y Combinator in 2014? http://www.immunityproject.org http://www.immunityproject.org
- hayksaakian 8y ago
  Check out the linkedin profiles for people on this page http://www.immunityproject.org/team http://www.immunityproject.org/team Seems like some of them have left, otherwise still active? The website has not had any new updates since 2016 though which is worrying.
NN88 8y ago
>One important caveat to any such approach is that the patient would still be vulnerable to a form of H.I.V. called X4, which employs a different protein, CXCR4, to enter cells. >“This is only going to work if someone has a virus that really only uses CCR5 for entry — and that’s actually probably about 50 percent of the people who are living with H.I.V., if not less,” said Dr. Timothy J. Henrich, an AIDS specialist at the University of California, San Francisco. >Even if a person harbors only a small number of X4 viruses, they may multiply in the absence of competition from their viral cousins. There is at least one reported case of an individual who got a transplant from a delta 32 donor but later rebounded with the X4 virus. (As a precaution against X4, Mr. Brown is taking a daily pill to prevent H.I.V. infection.) This...leaves a lot to be desired...
fuckinFag 8y ago
Get bent.
jjtheblunt 8y ago
entirely implausible, if the virus rewrites the host dna via rna...a rootkit in biology
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YesThatTom2 8y ago
I call bullshit. As a kid who grew up in the 1980s and suffered through endless funerals and stuff, I also observed that any time a research lab was nearly out of funds, they'd send out a press release claiming something that sounded important, but wasn't. The local congress person would find funds to keep the research group going and "save the day". The research that was "saved" was usually an impressive-sounding tidbit that wasn't really impressive. "Kills HIV in the test-tube" became a red flag for me... that was always an indicator something fishy was going on. HIV is easy to kill. oxygen kills it. Sadly, you can't pump pure oxygen into the blood or the patient dies. Killing HIV in a testtube was the experiment you did to get PR and more funding. One person "cured" is an anecdote, not a breakthrough. Occasionally people's bodies cure themselves. After 12 years of trying someone was "cured"? I'll believe it when I see it done in a repeatable way. Sorry for being such a downer. I've had my heart broken too many times.
- johnmarcus 8y ago
  it wasn't all bullshit though, you were just to young to understand the concept of how science works. you thought breakthroughs were cure-all's, when really they were incremental improvements. By the 90's, they had meds which has allowed patience to live long and relatively normal lives - those meds came from the scientific breakthroughs of the 80's which you despise so much. Likewise, no one is saying this a practical cure - but scientifically speaking these are two individuals whom have been relieved of the disease, thoroughly confirmed, and now with two patients, a replicated process (however impractical it is). Sorry for your losses, just saying, you shouldn't 'shit' on peoples hard scientific work because it didn't fulfill your hopes and dreams.
- jobigoud 8y ago
  One thing I distinctly remember about HIV in the early 90's is researchers saying that if we didn't figure out a cure in the next few years we would never find it. I think due to mutability. I'm not sure exactly what they based their assertions on.
- matthewmacleod 8y ago
  Yeah, well you haven’t been paying enough attention. As a result of funding, drugs are now widely and cheaply available that effectively suppress HIV and, when taken as a prophylactic, prevent infection. Decades of research means that science now has a clearer understanding of the mechanisms behind HIV and has used that to develop tools to control it. Because it is not “cured” yet does not mean that funding research is bad.
HNLurker2 8y ago
Didn't Asimov died of HIV from wrongly transplant
- HNLurker2 8y ago
  https://old.reddit.com/r/todayilearned/comments/akylvy/til_issac_asimov_contracted_hiv_from_a/ https://old.reddit.com/r/todayilearned/comments/akylvy/til_i...
neokantian 8y ago
CCR5 is the protein that He Jiankui Mengele, a scientist in China, claimed to have modified with gene editing in at least two children
HeppyCamperBob 8y ago
Good, because the New York Times paywall gave me AIDS.
edoo 8y ago
My first thought is to short condom manufacturers but when I think about it most of them are one of many many brands of a conglomerate.
peter303 8y ago
The scary thing is that humanity is highly susceptible to another plague whether it is STD like AIDS or some other transmission. We live in contact with strangers. Air travel can carry a diseaes around the world in a couple of days. This was depicted in many scifi movies like Contagion. And gays have not really changed their habits. If you read the profiles on Grindr, the gay hookup app, many people claim to be on the prophalyptic PReP drug regime which allows the more pleasurable and dangerous version of unprotected sex. It wont be HIV but something new. Humankind has lived with plagues for 10,000 years since agriculture and urbanization has created the population density that allow plagues to flourish. There are plenty of stories where some plague kills off half to 90% of a village goinf all the way back to Classical Greece.
- onychomys 8y ago
  HIV is a disease of gay men in the western world, but that's not true elsewhere. Most infections in Russia are from intravenous drug use. Most infections in sub-Saharan Africa are from heterosexual sex. Your science is bad.
  - foldr 8y ago
    HIV disproportionally affects gay men in the west, but only about 50% of HIV+ people in the US are gay.
- ausbah 8y ago
  >The scary thing is that humanity is highly susceptible to another plague whether it is STD like AIDS or some other transmission. i would agree that humanity is highly susceptible to another widespread pandemic, plague, or whatever else one wishes to call - but i feel it is inappropriate to compare STDs, especially HIV (you don't trasmit AIDs), to easily transmittable diseases you don't "catch" HIV just by being in relative contact with someone who has it, that sort of talk just rehashes the thoroughly debunked talking points that emerged from the anti-gay stances and mass hysteria around HIV in the 80s-90s yes globalization and increased connectivity has allowed HIV and other STDs to spread across the globe, but it hasn't made transmission from person to person any easier and HIV isn't only spread through being gay, as others in this thread have pointed out - HIV emergence in the gay population mainly occurs in the West, it is also a prominent issue because of needle exchanges, unprotected sex among the heterosexual population, and other methods that allow for the transmission of bodily fluids between peoples
peter303 8y ago
This was only the second cure of several dozen similar marrow transplant procedures ech costing on the order of six figures. And with 50 million around the world infected and 40 years of searching for a reliable cure. Its far more likely that a million were saved by having a rare mutation (1% population) that prevents HIV infection. The recently disgraced Chinese scientist used CRSPER/CAS9 genetic engineering on human embryros to induce this immunity into people who lacked it. The experiment was conducted in a totally unethical way with the scientist under criminal investigation. But the goal was noble.
dana321 8y ago
Perhaps the bone marrow was from one of the rare occurences of people who are immune to HIV
deleted 8y ago
[deleted]
wuschel 8y ago
The infection with the HIV virus leads to the AIDS decease. It is sad to see that even the NYT can't get things straight when it comes to science. I am very curious about the paper/data. For now, the typical newspaper headline does not mean a thing to me.
- onychomys 8y ago
  Assuming you meant "disease" instead of "decease", that's literally what the very first line in the article says. I'm in HIV research, and I have only the most minor nitpicks with the article's science.
  - wuschel 8y ago
    Indeed, I meant disease. I meant the title, not the article itself. So much for making quick and precise comments on HN.
- lainon 8y ago
  paper is online now: https://www.nature.com/articles/s41586-019-1027-4 https://www.nature.com/articles/s41586-019-1027-4
  - wuschel 8y ago
    Thanks!
phkahler 8y ago
Bone marrow transplants are a very high risk procedure. Something like 50 percent work, while the rest die shortly after. I knew a guy with cancer that did it as a last resort treatment. They killed all the marrow (whatever kind of cells, I'm not a doctor) and reintroduced some to take over. It took. And then they found the sample they reintroduced (they used his own) was tainted with cancer. He died shortly after. Had it not been tainted he would have been cured. Taking the cells from someone else means getting it cancer-free but also means higher risk it won't work. It also provides the opportunity to give the person an AIDS-proof immune system (which some people have). This is not a generally usable cure, but it is cool AF when it works.
- vagab0nd 8y ago
  Is that why people freeze and save their stem cells? Would it help in this case?
  - phkahler 8y ago
    I think that's the type of scenario they think might be possible some day. I'm not sure if there are any actual treatments that rely on frozen stem cells. Turns out you can convert some cells to stem cells, and there are some other sources.

Kye 8y ago

Caveat: one kind of HIV. >> "This is only going to work if someone has a virus that really only uses CCR5 for entry — and that’s actually probably about 50 percent of the people who are living with H.I.V., if not less"

burlesona 8y ago
Yes, but an actual cure for up to half of people with HIV would still be a huge positive.
- WrtCdEvrydy 8y ago
  Standby for insulin pricing!
  - deleted 8y ago
    [deleted]
  - lojack 8y ago
    Which is completely irrelevant to this because insulin isn’t a cure and has been around for nearly a century.
  - biesnecker 8y ago
    Insulin pricing would still be a lot cheaper than the anti-retrovirals are today I think.

Herodotus38 8y ago

This is using a stem cell transplant again like the first person which carries a high risk of lifelong complications and death. While awesome, this is not a realistic or great option for patients without another issue needing a stem cell transplant. With modern HAART therapy one is expected to live as long as the average non-HIV infected patient in the US.

fastball 8y ago
HIV is still transmissible even with HAART therapy, so I'm not sure how it's relevant to the discussion of a cure.
- woofyman 8y ago
  Undetectable also means non transmissible.
  - toomuchtodo 8y ago
    Bold claim. How recent are HPV tests? Edit: While my comment came from caution due to historical human hubris, it appears I am wrong: “According to the Centers for Disease Control and Prevention (CDC), a person with an undetectable viral load has “effectively no risk” of sexually transmitting HIV. In 2016, the Prevention Access Campaign launched the U=U, or Undetectable = Untransmittable, campaign.”
    - pryce 8y ago
      That claim isn't a bold assessment of the medical literature at all, it's actually widely held to by the medical organizations responsible for HIV treatment and prevention. Here [1] is for instance an article referencing this claim, describing it as "based on strong scientific evidence" that was peer reviewed published by the journal of the American Medical Association. (EDIT: it's important to add the caveat, which is that this claim is about sexual transmission only, and does not cover pregnant-mother-to-child transmission or intravenous needle sharing). Also your comment now refers to "HPV" which is the name of a different disease. [1] https://jamanetwork.com/journals/jama/article-abstract/2720997 https://jamanetwork.com/journals/jama/article-abstract/27209...
      - toomuchtodo 8y ago
        I refer to HPV as a case study in humans not having tests available for a communicable disease (no HPV test exists for men) and underestimating it’s communicability (not to mention it’s role in causing several types of cancer). Apologies if you thought I was confusing HPV and HIV. Too often we think we’re smarter than we are, and the consequences can be damning. Hence why I said its a bold claim that undetectable means it can’t be transmitted. Are we absolutely sure? Because if we’re not, someone could acquire a life long chronic disease that would otherwise have been preventable. But the CDC says undetectable says no transmission; I hope they’re right in 100% of transmission scenarios.

temporalparts 8y ago

> But rearming the body with immune cells similarly modified to resist H.I.V. might well succeed as a practical treatment, experts said. Do people know what is the existing literature on injecting or transplanting different or modified immune cells into someone as a general class of cures? Seems like this could generalize into something of an alternative to vaccine (or a different class of cures).

zaroth 8y ago
There’s a massive arm of cancer research devoted to exactly this, called immunotherapy. It’s where many of the best new treatments are being discovered lately. People are calling it the new chemo. It’s particular promising in leukemia, for example. Typically involves injecting a growth factor and then harvesting stem cells from peripheral blood (as supposed to having to go into the marrow directly), then processing the cells in some way to make them more antagonistic to the cancerous mutations. In some cases the cancerous cells will be tagged with some marker that can then be used as a target site the extracted cells can be trained on. Then the patient’s own stem-cells are transplanted back into their body to do their work. Sometimes the patient gets ablated before reintoducing the new cells. That’s called an autologous (“auto”) stem-cell transplant.

xfitm3 8y ago

While this treatment course doesn't appear to be without serious side effects or scale well let's not lose sight of the real win here. Reinforcing that a cure is possible. "The surprise success now confirms that a cure for H.I.V. infection is possible, if difficult, researchers said."

ddebernardy 8y ago
^ So much this. For everyone of us who know and care about someone who has HIV, and for everyone who has it, it's basically a sunbeam of hope -- regardless of how effective or not it turns out to be in practice.
- gregimba 8y ago
  Especially people who both parents died of age like my siblings. It gives you hope for a future where that won't be the outcome.

pgrote 8y ago

The existing research of the berlin patient (https://en.wikipedia.org/wiki/Timothy_Ray_Brown https://en.wikipedia.org/wiki/Timothy_Ray_Brown) indicates the likely elimination of HIV was graft vs. host disease (https://en.wikipedia.org/wiki/Graft-versus-host_disease#HIV_elimination https://en.wikipedia.org/wiki/Graft-versus-host_disease#HIV_...). The NY Times doesn't mention graft vs. host, but the doctor treating the berlin patient says no one else was cured undergoing the treatment the berlin patient underwent. According to records, 6 additional people were thought to be cured. I couldn't find any follow-up on them. (https://www.newscientist.com/article/mg23431244-400-immune-war-with-donor-cells-after-transplant-may-wipe-out-hiv/ https://www.newscientist.com/article/mg23431244-400-immune-w...)

h3throw 8y ago
Feels a bit like correlation vs causation. It's unclear what the mechanism of action in GvH would be and it's also clear in this case that GvH was not necessary.
rincebrain 8y ago
[1] suggests this was also true here, but AFAICT the other patients they've tried this on to see if it was just graft versus host all wound up relapsing (I swear there was another study of this negative outcome with n>2, but I'm not turning it up, so maybe I'm full of it). [2] Though [3] claims another set of experiments with this resulted in 5 cured/undetectable patients and one remission who was allegedly an odd duck out in terms of treatment (cord blood versus bone marrow), [1] - https://www.theguardian.com/society/2019/mar/05/london-patient-becomes-second-man-to-be-cleared-of-aids-virus https://www.theguardian.com/society/2019/mar/05/london-patie... [2] - https://www.nature.com/news/hopes-of-hiv-cure-in-boston-patients-dashed-1.14324 https://www.nature.com/news/hopes-of-hiv-cure-in-boston-pati... [3] - https://annals.org/aim/article-abstract/2707334/mechanisms-contribute-profound-reduction-hiv-1-reservoir-after-allogeneic-stem https://annals.org/aim/article-abstract/2707334/mechanisms-c...

rayiner 8y ago

As a kid who grew up in the 1990s, I consider this the biggest technological advance in my lifetime. HIV was a death sentence back then. Arthur Ashe died of it in 1992, and Magic Johnson announced he had it in 1991. It was in our minds right up there with global warming and the hole in the ozone layer as a existential threat to humanity. And now... a 20-something who begins antiretroviral therapy today can expect to live into his or her late 70s. It's a scientific miracle.

newsbinator 8y ago
As a fellow 90's kid who read almost every book Isaac Asimov wrote, I was shocked to learn he died in 1992 from AIDS acquired previously from a blood transfusion. The sooner humanity can mostly forget that HIV/AIDS was ever a thing, the better.
- rrishi 8y ago
  I am a huge fan of Asimov too. I didn't know he died of AIDS. That's unfortunate.
  - phlakaton 8y ago
    He and his family kept that fact private, I understand, until years after his passing, because of the enormous stigma around it. That stigma remains one of the most tragic consequences of the disease, as Randy Shilts so devastatingly documented.
- v1vek 8y ago
  I have read most, but not all of his work but did't know that's how he died. I wasn't old enough in the 90s to understand HIV/AIDS completely but remember it being a death sentence (I remember a rumor that you could get it by using public toilets)
  - billfruit 8y ago
    Reportedly his family didn't publicize the matter at the time, due to the prejudice it would have triggered. His auto biography also does not mention it. It was only made public by his family, several years after his death.

ausbah 8y ago

Personally, I wish what would really get attention in the realm of HIV treatments is invention and subsequent spread of "prevention" drugs like PrEP (significantly lowering chances of getting HIV if taken daily) and PEP ("fight off" HIV if possibly exposed to it in the last 72 hours), in addition to amazingly high level of quality that HIV therapies have reached such that if HIV can't be detected - its effectively untransmittable. Not trying to draw attention away from the potential significance of the article, would just like more of the "widespread", effective treatments get a little light.

joshlittle 8y ago
Not gonna disagree; the treatments are good and getting better for PLWHs - side effects are nearly nonexistent on the day to day and better than they were in the long run. And PrEP / nPEP are miracles at reducing seroconversions in high risk groups/persons exposed. We do need a cure. The damage done to the body of an HIV positive person who’s undetectable, on HAART/meds is progressive, permanent, and irreversible. Even on treatment, chronic inflammation of the immune system adds a lot of undue stress to the body. While I’m not at risk for any AIDS defining illnesses/cancers, I’ve still got a very high risk of other cancers compared to someone who’s HIV-negative. I’m grateful for laws protecting people like me with pre existing conditions - which forces my insurance company to fully cover my $6000 US/mo in HAART treatment. (Symtuza/Tivicay if curious) What’s the amount of money big pharma will make over the course of my life alone? Millions if they can keep this up. How great could life be without HIV in it for good? I’d like to find out, or at least maybe get my doctor to stop asking me to fill out an advanced care directive. I’m thankful otherwise that at 32 I’m fit, in perfect health, and undetectable. Someday I hope i’ll change my status to “cured.”
torstenvl 8y ago
I'm on PrEP. It was astoundingly hard to get on. So many primary care doctors have no idea what it is or why to prescribe it.
- rickycook 8y ago
  in australia at least these days, i’ve gone to arbitrary doctors for my 3mo tests and things and almost always they’ve offered to prescribe me PrEP... i’m already on it, but it seems here it’s being promoted by almost everyone!

canada_dry 8y ago

I assume it's the same method they've successfully used to eliminate Multiple Sclerosis. https://www.bbc.com/news/health-43435868 https://www.bbc.com/news/health-43435868 How are we not pumping billions more into stem cell research?!?

deleted 8y ago
[deleted]
save_ferris 8y ago
Perhaps because it's controversial on religious grounds. W. vetoed multiple embryonic stem cell research bills during his administration, the Catholic Church still formally opposes it[0], as well as the Southern Baptist Convention. [0]: http://www.usccb.org/issues-and-action/human-life-and-dignity/stem-cell-research/index.cfm http://www.usccb.org/issues-and-action/human-life-and-dignit...
- toomuchtodo 8y ago
  My understanding is that embryonic stem cells are no longer needed for today’s stem cell research. If a domain expert sees this, call me out if I’m wrong. https://www.scientificamerican.com/article/human-stem-cells-no-embryo/ https://www.scientificamerican.com/article/human-stem-cells-... (Human Stem Cell Breakthrough: No Embryos Required, 2007)
- rayiner 8y ago
  This treatment was actually done with stem cells from an adult donor.[1] (Stem cell research is a bit of a black eye for liberals in my opinion. W. Bush's restrictions on embryonic stem cell research were not particularly draconian. It was limited to use of federal funds, and even then only restricted creating new embryonic stem cell lines. And the left was just wrong on how much could be done with adult stem cells. That is not to say that adult stem cells are an alternative in every case, but rather that a lot of the folks calling Republicans anti-science were themselves wrong on the science of how promising adult stem cell research was.) [1] I'll also add: the question of whether destroying embryos for research is moral is not a religious one, but rather a political issue on which religions have strong opinions. So long as the government makes it illegal to kill people, it must as a purely political question define what a "person" is and what the exceptions are to that rule. Thus, the death penalty is a political issue rather than a religious issue, even though e.g. the Catholic church and several protestant denominations officially condemn it.

bcks 8y ago

Related: whatever happened to The Immunity Project, the AIDS vaccine funded by Y Combinator in 2014? http://www.immunityproject.org http://www.immunityproject.org

hayksaakian 8y ago
Check out the linkedin profiles for people on this page http://www.immunityproject.org/team http://www.immunityproject.org/team Seems like some of them have left, otherwise still active? The website has not had any new updates since 2016 though which is worrying.

NN88 8y ago

>One important caveat to any such approach is that the patient would still be vulnerable to a form of H.I.V. called X4, which employs a different protein, CXCR4, to enter cells. >“This is only going to work if someone has a virus that really only uses CCR5 for entry — and that’s actually probably about 50 percent of the people who are living with H.I.V., if not less,” said Dr. Timothy J. Henrich, an AIDS specialist at the University of California, San Francisco. >Even if a person harbors only a small number of X4 viruses, they may multiply in the absence of competition from their viral cousins. There is at least one reported case of an individual who got a transplant from a delta 32 donor but later rebounded with the X4 virus. (As a precaution against X4, Mr. Brown is taking a daily pill to prevent H.I.V. infection.) This...leaves a lot to be desired...

fuckinFag 8y ago

Get bent.

jjtheblunt 8y ago

entirely implausible, if the virus rewrites the host dna via rna...a rootkit in biology

qweqs 8y ago

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YesThatTom2 8y ago

I call bullshit. As a kid who grew up in the 1980s and suffered through endless funerals and stuff, I also observed that any time a research lab was nearly out of funds, they'd send out a press release claiming something that sounded important, but wasn't. The local congress person would find funds to keep the research group going and "save the day". The research that was "saved" was usually an impressive-sounding tidbit that wasn't really impressive. "Kills HIV in the test-tube" became a red flag for me... that was always an indicator something fishy was going on. HIV is easy to kill. oxygen kills it. Sadly, you can't pump pure oxygen into the blood or the patient dies. Killing HIV in a testtube was the experiment you did to get PR and more funding. One person "cured" is an anecdote, not a breakthrough. Occasionally people's bodies cure themselves. After 12 years of trying someone was "cured"? I'll believe it when I see it done in a repeatable way. Sorry for being such a downer. I've had my heart broken too many times.

johnmarcus 8y ago
it wasn't all bullshit though, you were just to young to understand the concept of how science works. you thought breakthroughs were cure-all's, when really they were incremental improvements. By the 90's, they had meds which has allowed patience to live long and relatively normal lives - those meds came from the scientific breakthroughs of the 80's which you despise so much. Likewise, no one is saying this a practical cure - but scientifically speaking these are two individuals whom have been relieved of the disease, thoroughly confirmed, and now with two patients, a replicated process (however impractical it is). Sorry for your losses, just saying, you shouldn't 'shit' on peoples hard scientific work because it didn't fulfill your hopes and dreams.
jobigoud 8y ago
One thing I distinctly remember about HIV in the early 90's is researchers saying that if we didn't figure out a cure in the next few years we would never find it. I think due to mutability. I'm not sure exactly what they based their assertions on.
matthewmacleod 8y ago
Yeah, well you haven’t been paying enough attention. As a result of funding, drugs are now widely and cheaply available that effectively suppress HIV and, when taken as a prophylactic, prevent infection. Decades of research means that science now has a clearer understanding of the mechanisms behind HIV and has used that to develop tools to control it. Because it is not “cured” yet does not mean that funding research is bad.

HNLurker2 8y ago

Didn't Asimov died of HIV from wrongly transplant

HNLurker2 8y ago
https://old.reddit.com/r/todayilearned/comments/akylvy/til_issac_asimov_contracted_hiv_from_a/ https://old.reddit.com/r/todayilearned/comments/akylvy/til_i...

neokantian 8y ago

CCR5 is the protein that He Jiankui Mengele, a scientist in China, claimed to have modified with gene editing in at least two children

HeppyCamperBob 8y ago

Good, because the New York Times paywall gave me AIDS.

edoo 8y ago

My first thought is to short condom manufacturers but when I think about it most of them are one of many many brands of a conglomerate.

peter303 8y ago

The scary thing is that humanity is highly susceptible to another plague whether it is STD like AIDS or some other transmission. We live in contact with strangers. Air travel can carry a diseaes around the world in a couple of days. This was depicted in many scifi movies like Contagion. And gays have not really changed their habits. If you read the profiles on Grindr, the gay hookup app, many people claim to be on the prophalyptic PReP drug regime which allows the more pleasurable and dangerous version of unprotected sex. It wont be HIV but something new. Humankind has lived with plagues for 10,000 years since agriculture and urbanization has created the population density that allow plagues to flourish. There are plenty of stories where some plague kills off half to 90% of a village goinf all the way back to Classical Greece.

onychomys 8y ago
HIV is a disease of gay men in the western world, but that's not true elsewhere. Most infections in Russia are from intravenous drug use. Most infections in sub-Saharan Africa are from heterosexual sex. Your science is bad.
- foldr 8y ago
  HIV disproportionally affects gay men in the west, but only about 50% of HIV+ people in the US are gay.
ausbah 8y ago
>The scary thing is that humanity is highly susceptible to another plague whether it is STD like AIDS or some other transmission. i would agree that humanity is highly susceptible to another widespread pandemic, plague, or whatever else one wishes to call - but i feel it is inappropriate to compare STDs, especially HIV (you don't trasmit AIDs), to easily transmittable diseases you don't "catch" HIV just by being in relative contact with someone who has it, that sort of talk just rehashes the thoroughly debunked talking points that emerged from the anti-gay stances and mass hysteria around HIV in the 80s-90s yes globalization and increased connectivity has allowed HIV and other STDs to spread across the globe, but it hasn't made transmission from person to person any easier and HIV isn't only spread through being gay, as others in this thread have pointed out - HIV emergence in the gay population mainly occurs in the West, it is also a prominent issue because of needle exchanges, unprotected sex among the heterosexual population, and other methods that allow for the transmission of bodily fluids between peoples

peter303 8y ago

This was only the second cure of several dozen similar marrow transplant procedures ech costing on the order of six figures. And with 50 million around the world infected and 40 years of searching for a reliable cure. Its far more likely that a million were saved by having a rare mutation (1% population) that prevents HIV infection. The recently disgraced Chinese scientist used CRSPER/CAS9 genetic engineering on human embryros to induce this immunity into people who lacked it. The experiment was conducted in a totally unethical way with the scientist under criminal investigation. But the goal was noble.

dana321 8y ago

Perhaps the bone marrow was from one of the rare occurences of people who are immune to HIV

deleted 8y ago

[deleted]

wuschel 8y ago

The infection with the HIV virus leads to the AIDS decease. It is sad to see that even the NYT can't get things straight when it comes to science. I am very curious about the paper/data. For now, the typical newspaper headline does not mean a thing to me.

onychomys 8y ago
Assuming you meant "disease" instead of "decease", that's literally what the very first line in the article says. I'm in HIV research, and I have only the most minor nitpicks with the article's science.
- wuschel 8y ago
  Indeed, I meant disease. I meant the title, not the article itself. So much for making quick and precise comments on HN.
lainon 8y ago
paper is online now: https://www.nature.com/articles/s41586-019-1027-4 https://www.nature.com/articles/s41586-019-1027-4
- wuschel 8y ago
  Thanks!

phkahler 8y ago

Bone marrow transplants are a very high risk procedure. Something like 50 percent work, while the rest die shortly after. I knew a guy with cancer that did it as a last resort treatment. They killed all the marrow (whatever kind of cells, I'm not a doctor) and reintroduced some to take over. It took. And then they found the sample they reintroduced (they used his own) was tainted with cancer. He died shortly after. Had it not been tainted he would have been cured. Taking the cells from someone else means getting it cancer-free but also means higher risk it won't work. It also provides the opportunity to give the person an AIDS-proof immune system (which some people have). This is not a generally usable cure, but it is cool AF when it works.

vagab0nd 8y ago
Is that why people freeze and save their stem cells? Would it help in this case?
- phkahler 8y ago
  I think that's the type of scenario they think might be possible some day. I'm not sure if there are any actual treatments that rely on frozen stem cells. Turns out you can convert some cells to stem cells, and there are some other sources.