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5th person confirmed to be cured of HIV
- Vecr 4y ago[flagged]
- NovemberWhiskey 4y agoApologies, I know nothing about this at all, but why is it more surprising for HIV than other viral diseases that do have successful cures (like hepatitis C)?
- notahacker 4y agoIn simple terms, rather than always using a cell it takes over to make as many copies of itself as possible which then circulate and get dealt with by the (possibly boosted) immune system, HIV can hide itself in human DNA and let the normal human cell division process create a reservoir of apparently normal human cells which can produce copies of the virus in future
- bboygravity 4y agoTLDR: HIV edits your genome to add itself into it.
- Snoozus 4y agoIt's called a retrovirus. There is a handful of them dangerous to humans.
- asveikau 4y agoI don't know much about this, but I read that some primates have endemic SIV and don't get sick, whereas some other species of primate will die of AIDS after exposure to SIV. For example, Wikipedia on SIV says that ~90% of female African green monkeys (vervets) have SIV, and don't get AIDS. From there one imagines that a primate species on first exposure to the virus has it as a deadly disease, but sometimes they evolve a resistance to getting sick from it, without eradicating the virus.
- elil17 4y ago>> I think it's quite likely that at least one of these 5 people have... something in their body that could be transfected into another person's cells and cause an active HIV infection. No, they definitely don't. It's well known[1] that people without detectable levels of HIV in their blood cannot transmit HIV to other people. That is true for people who are simply receiving normal treatments (see: https://www.nih.gov/news-events/news-releases/science-clear-hiv-undetectable-equals-untransmittable https://www.nih.gov/news-events/news-releases/science-clear-...). It is certainly also true for these transplant recipients. Edit: [1]: Specifically, researchers have never observed transmission from someone with undetectable viral load, despite many large studies searching for such an event
- nostromo 4y agoWhat you've said is true, but I'd add that there are worrying number of HIV+ men that have stopped disclosing their status to sexual partners because they've heard that "undetectable = untransmissible." While that does seem to be true, there are a number of problems with this: 1. Not everyone takes their medications exactly as prescribed. 2. Lots of folks on antiretroviral therapy are not undetectable, or may move between undetectable and detectable over time. It's important that people still disclose their status to sex partners.
- School-Cotton 4y ago> there are worrying number of HIV+ men that have stopped disclosing their status to sexual partners because they've heard that "undetectable = untransmissible." I thought that was the entire point of the “undetectable = untransmissible” campaign — freeing people from worrying about passing it to others and having to live with a scarlet letter, which is an incentive to get treated > It’s important that people still disclose their status Why?
- Retric 4y agoBecause having undetectable levels on day 1 doesn’t mean you have undetectable levels on day X and people don’t test every single day. Further, if you’re in a long term relationship for years and your status changes you don’t want to suddenly have a big secret come out.
- nathanvanfleet 4y agok thanks, so I guess you've studied this for as long as it took to write 129 words on the subject. I am going to have to be way more interested in the actual people who are studying and experimenting with this at this point, I can't allocate any interest at all in your 129 word paper on the subject.
- biosboiii 4y agoAll four of these patients had undergone stem cell transplants for their blood cancer treatment. Their donors also had the same HIV-resistant mutation that deletes a protein called CCR5, which HIV normally uses to enter the cell. Only 1% of the total population carries this genetic mutation that makes them resistant to HIV. The article is horribly wrong about CCR5 being the only pathway of the HI Virus to infect your cells and ultimately cause AIDS. A problem of this approach is that, while CCR5 is the major co-receptor by which HIV infects cells, it is not the only such co-receptor. It is possible that under selective pressure HIV will evolve to use another co-receptor. [1] Why this treatment still worked is because: However, examination of viral resistance to AD101, molecular antagonist of CCR5, indicated that resistant viruses did not switch to another co-receptor (CXCR4), but persisted in using CCR5: they either bound to alternative domains of CCR5 or to the receptor at a higher affinity. However, because there is still another co-receptor available, it is probable that lacking the CCR5 gene does not make one immune to the virus; it would simply be more challenging for the individual to contract it. [1] So a mixture of anti-retroviral treatments, which suppress the HIV replication to a point of not showing up in PCR tests anymore (while taking the medication), and (partially?) inhibiting the remaining viruses from infecting cells via the CCR5 pathway, further limiting their replication, caused these patients to be cured. I don't know if the replication slowed down so much that their body was able to kick HIV out once and for all, or blocked it outright because the already reduced number of viruses simply could not beat the odds of infecting via a alternative pathway. Kudos to the researchers! Why is this important: The CRISPR babies[2] had this exact gene removed, and everybody claimed that he cured them from ever getting HIV, even though it's simply not true. Note that there are also drugs which disable CCR5, without gene modification (Selzentry). [1] https://en.wikipedia.org/wiki/CCR5 https://en.wikipedia.org/wiki/CCR5 [2] https://en.wikipedia.org/wiki/He_Jiankui_affair https://en.wikipedia.org/wiki/He_Jiankui_affair
- eckesicle 4y agoIt's been a few years now but I used to work on research on this particular alternative receptor. To handwave and simplify a bit CCR5 is the dominant pathway for the virus to spread in a healthy patient. HIV tends to mutate in patients from attaching to CCR5 (called phenotype R5) to CXCR4 (called X4) once the immune system is weaker. Patients with the X4 are not as infectious as a healthy immune system can fend it off. So CCR5 is more or less the only pathway for the virus to infect a healthy host, as far as I can remember.
- deleted 4y ago[deleted]
- starik36 4y ago[flagged]
- moffkalast 4y agoJust 38.4 million more to go.
- vore 4y agoStem cell transplantation is probably not the most effective way to end HIV due to its severe risks and cost: it's much more likely preventative measures like PrEP/PEP and treatments like HAART are much more viable long-term solutions.
- s3p 4y ago> The stem cell transplantation is a complicated procedure that comes with many risks, and it is too risky to offer it as a cure for everyone with HIV. Maybe it's just me but I hate when people/articles generalize like this. What are the risks? What are the benefits? What is the SPECIFIC hazard to health that is occurring? They just stick to general statements, because, in my opinion, they don't want to do the research. Either way the news itself is good to hear.
- vore 4y agoStem cell transplantation is usually performed by bone marrow transplant, which is a pretty risky procedure: it involves destroying the recipient's own bone marrow to introduce the donor bone marrow, which can leave the recipient without significant numbers of white blood cells for a while, making them extremely vulnerable to infection. In contrast, HAART for HIV is far less risky and far more safe, allowing people with HIV to live basically a normal life as long as their viral loads stay at undetectable limits.
- torstenvl 4y agoThat's the received wisdom, but it really seems trite. HAART leaves people extremely vulnerable to infection as well, after all. The difference is that HAART means that point will come at some unpredictable point in the future, whereas a bone marrow transplant makes the window more predictable. And beyond that, it fails to consider the risks of decades of really toxic medication. Is a bone marrow transplant really worse than decades of liver damage followed by developing AIDS eventually anyway? Maybe, maybe not, but dismissing the heavy questions of a persons life with "basically normal" is not helpful.
- chimeracoder 4y ago> HAART leaves people extremely vulnerable to infection as well, after all. The difference is that HAART means that point will come at some unpredictable point in the future, > And beyond that, it fails to consider the risks of decades of really toxic medication. Is a bone marrow transplant really worse than decades of liver damage followed by developing AIDS eventually anyway? This is an outdated and objectively incorrect description of HAART. > but dismissing the heavy questions of a persons life with "basically normal" is not helpful. "Basically normal" is an approximately correct description of the life of most HIV+ people who have easy access to HAART. What's not helpful is responding to that with fearmongering based on incorrect and/or grossly outdated information.
- iLoveOncall 4y agoDespite all the caveats and potential inaccuracies of the article, what a time to be alive!
- jeffreyrogers 4y agoRecently there was a post on HN about some child whose genetic disease was cured by inserting DNA (can't remember the specifics). I wonder if something similar could be done with HIV. Obviously you'd have to insert a mutation for the CCR5 protein. Then the problem is you have all this bone marrow that's still producing white blood cells of the old type, so you'd need some way of killing off the old bone marrow cells without the right mutation and replacing them with the new ones.
- joering2 4y agoDup of the story I posted hour earlier from the source I believe better describe the whole situation: https://news.ycombinator.com/item?id=34871755 https://news.ycombinator.com/item?id=34871755
- remram 4y agoIs it the 3rd or 5th then?
- ccooffee 4y agoI've had an allogenic stem cell transplant. It was hell. I no longer have cancer, so it was worth it. But HIV/AIDS (with standard treatment and testing) no longer significantly reduces life expectancy. I have a hard time imagining a future where allogenic stem cell transplants are used to treat HIV. The procedures are incredibly risky and carry long term consequences (and in many cases, like mine, also unbearably painful for weeks). To me, the most likely practical consequence of these findings is to spur on interest in using CRISPR (or other in-vivo genetic modification strategies) to alter the genome of an HIV patient to be "immune" to HIV. (A similar idea is used in treatment of some blood cancers. Chase the rabbit-hole of "CAR T Cell therapy" to get started.)
- duxup 4y agoI read a little about allogenic stem cell transplants and it really sounds risky and more of a last chance type option.
- ccooffee 4y ago"Last chance" describes both the way it was introduced to me by my medical team, and the circumstances around my SCT. I don't know how factually accurate it is, but my medical team had said there's about a 30% mortality rate caused by the SCT within about 90 days. (And, prior to chemotherapy ceasing to work, I'd been repeatedly reassured by medical staff with "chemo sucks but it isn't gonna kill you like a stem cell transplant would!")
- elgenie 4y agoThis explanation for the technique’s general inapplicability is touched on in the article. It sounds like all of the HIV-cured were people that had a blood cancer that was, presumably, not responding to chemo, and for which they needed to get a new blood-making system grafted in. And, since this extremely risky procedure was a sunk cost, they rolled in the stem cell donor having an HIV resistant mutation as a might-as-well-since-we’re-in-there freebie while treating the blood cancer with a last ditch effort. Inducing the HIV resistant mutation by other means is clearly the general way to go.
- matt3210 4y agoLooks like the hiv resistant donors are more evolved!
- elamje 4y agoNot endorsing the credibility of this article, but if you think this is interesting, you'll likely think https://www.variantbio.com https://www.variantbio.com is awesome. They scour the globe looking for people groups, families, regions, etc. that have extremely rare immunities and other outlier characteristics in order to sequence their DNA.
- 71a54xd 4y agoThis is great, but if you have a history of risky behavior or literally having HIV you shouldn't be able to donate blood.
- ccooffee 4y ago1. You completely missed the point of the article. The (formerly) HIV-positive patient RECEIVED a donation. 2. HIV is already screened for in blood donations. (Whole blood donations also come with a long list of questions which gauge for some things you might consider "risky behavior", like injection drug use or sexual contact with sex workers.) 3. With proper treatment, most HIV patients today have a non-detectable viral load of HIV in their blood. This doesn't mean that they absolutely CANNOT transmit the virus, but that the quantity of virus is vanishingly small. To quote the NIH[0]: > While it is still possible to transmit HIV to others during [Chronic HIV infection], people who take ART exactly as prescribed and maintain an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex. [0] https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages...
- majikaja 4y agoSeems to me like every improvement in medical science will be accompanied by a corresponding decrease in individual responsibility. Just like hardware and software. I've heard young people basically say 'HIV isn't a big deal nowadays so no need to worry'.
- notmindthegap 4y agoThis is what technology does.
- flemhans 4y agoYeah - it's nice not to have to care about and be scared about stuff that is no longer relevant.
- majikaja 4y agoMaybe better to keep people a bit fearful, is what I'm saying.
- flemhans 4y agoI guess it's just different opinions. What I'm saying is that when given the opportunity to get rid of fear, we should. Same way I'm not afraid of wildlife attacking me, or cholera.
- majikaja 4y agoI probably won't die if I get food poisoning but I'm not going to go around eating raw meat for the thrill of it and expect the taxpayer to pay for me every time I get sick.
- bolanyo 4y agoAh, so underlying the 'moral' argument is the uncontrollable FEAR that you, a wealthy but unadventurous person, are somehow subsidizing other less wealthy people as they enjoy their lives.
- HeartStrings 4y agoNow do cancer next please
- grishka 4y agoMichael Levin is doing that. He's researching morphogenesis, but he also found that cancer is related to that. Basically, all cells communicate with each other with electric potentials to work towards a common goal, like forming an organ or a limb. Cancer happens when that communication is disrupted. It disappears when it's restored.
- deleted 4y ago[deleted]
- andrewstuart 4y agoThere's going to be alot of rich people with HIV wanting this.
- InCityDreams 4y agoPoor people, too.
- dustedcodes 4y ago> Only 1% of the total population carries this genetic mutation that makes them resistant to HIV. Wow, I didn't even know that you can be immune to HIV. It's only a matter of time before we have technologies to change our genetic code or at least the genetic code of two cells before they form an embryo.
- LeonM 4y ago> It's only a matter of time before we have technologies to change our genetic code or at least the genetic code of two cells before they form an embryo. I suggest watching the movie 'Gattaca' ;-) Seriously though, it is really good
- eimrine 4y ago> Wow, I didn't even know that you can be immune to HIV. HIV contains some code which use to convert a cell to be a zombie (afaik that cell's vulnerable place in cell's DNA is called CD4). But some people has that part of cell's DNA slightly different, not better not worse but different, therefore not vulnerable to that special code. The HIV for different cells is yet to be discovered. When we will have understanding of how to change the DNA code (implementing is really easy tbh), than any malintentioned person might develop new viruses shaping some known ones to be even more destructive.
- jokethrowaway 4y agoAren't we there yet? Gain of function research is exactly that and it gave us COVID
- eimrine 4y agoOpen-source is always good.
- biosboiii 4y agoRead my comment above, CCR5 gene deletion/mutation does not make you resistant to HIV, it can also infect via CXCR4
- tus666 4y agoThat's pretty amazing.
- Azurin 4y agoNow do long covid
- hulitu 4y ago> 5th person confirmed to be cured of HIV 40 milions to go :(
- jokethrowaway 4y agoNice, but I wonder how long before it's going to be an option for all those who want it (even ignoring whether managing HIV may be better then curing it). I'm still waiting for ocumetics bionic lenses to end glasses and contact lenses (ha ha ha, they're probably still collecting money from all the parties they should be destroying) and I lost hope we'll ever see RISUG, the male permanent but removable contraceptive without cancer-causing hormones.