4 ms·

60-year-old German man likely seventh person to be effectively cured from HIV

169 points by belter 2y ago

deleted 2y ago
[deleted]
init2null 2y ago
A 10% risk of death of a massive gamble compared to the alternatives. I can only hope this leads to a more useful solution than immune system replacement. I expect many would prefer a life of daily medication, or even shots every few months, which looks to be a promising form of treatment.
- jfengel 2y ago
  In this case there are no alternatives, because the patients have leukemia as well as HIV. For most people the current regimens for treating HIV are excellent. They can get the viral load down to undetectable levels, which makes it impossible to transmit. And the side effects are minimal.
  - rvba 2y ago
    Are undetectable levels really impossible to transmit?
    - somnic 2y ago
      As I understand it, large studies of couples where one partner has HIV with an undetectable viral load and the other does not have HIV have not recorded any cases of transmission through sexual activity. The question of whether it's "impossible" or "extremely unlikely" comes down more to philosophy than anything pragmatic at this point. Transmission through sharing needles we have less confidence around, because illegal drug use is harder to study. IIRC not everyone reaches an undetectable viral load through antiretroviral medication, so you do need to make sure that's the case. Pre-exposure prophylaxis and general safe sex practices like condoms can mitigate the risk for people with low-but-detectable viral load and their partners.
      - pavlov 2y ago
        I grew up in the 1990s with an overwhelming fear of HIV as a teenager. It still feels incredible that the virus is now undetectable and non-transmissible with medication that’s not much of a burden in one’s daily life. A cure for AIDS was much closer than anyone imagined in 1993. When everything seems dark and hopeless, this is one of the examples that always lifts my spirits. Humankind can achieve incredible things together.
        Gibbon1 2y ago
        While looking for something else on San Francisco's heath departments website I found the following two things. In San Francisco Deaths from AIDs dropped 70% from 1996 to 1997. That's in one year it went from a relentless death sentence to manageable chronic. While almost everyone that got HIV in the mid 80's are dead most people that got HIV in the mid 90's are still here. If that's not winning it's close.
        KennyBlanken 2y ago
        10,000 people a year die of AIDS in the US. Not even remotely close to "winning." I suspect a large portion of those deaths are due to poor sexual education thanks to christofascists, and people who don't get tested regularly because of poor access to family planning and reproductive health, again thanks to christofascists. All because Magical Sky God Said Abortion Bad. That and people who lose their healthcare and can't afford the meds because this country is the only developed nation in the world which does not treat healthcare like a universal human right, because corporations want to keep using health coverage to keep workers from switching jobs more freely, because they don't want a free labor market.
        mensetmanusman 2y ago
        It’s mostly through drug use, poverty, etc.
        rjzzleep 2y ago
        Isn’t that like a third of gun deaths in the USA? Personally for me this idea of trust that it’s undetectable and therefore non jtransmissible is not a risk I would recommend anyone to take, but at the same time we have to put things into relation no?
    - blue_dragon 2y ago
      My "pragmatic" analysis: I once spoke to a primary-care doctor about the risks of getting HIV through sex. The doctor told me that the risk of getting HIV the "typical way" (receiving anal sex) is about 1/72. Thus, for every 72 exposures, the recipient would contract HIV one time. This assumes that condoms are not used, and that the transmitter has an untreated HIV infection, which presumably has a high viral load. Transmission risk goes down by orders of magnitude for other forms of sex, until we get to receiving blowjobs, where the risk is literally nil. There are zero recorded cases of HIV caused by receiving a blowjob. In other words, HIV is actually kind of hard to get. You have to be very active, and not using protection, in order to get it. Or just be very, very unlucky. And that's with respect to untreated cases, which likely have high viral loads. This suggests to me that, for practical purposes, undetectable levels are impossible to transmit. Or as the Prep marketing executives would say, "U means U" - undetectable means untransmittable. Whether or not you're comfortable having sex with someone who is HIV+ but claims to have an undetectable viral load is a separate question entirely.
      - spencerchubb 2y ago
        > Whether or not you're comfortable having sex with someone who is HIV+ but claims to have an undetectable viral load is a separate question entirely. If someone has HIV, they would have to be extremely suicidal to forego taking the medication that would make them undetectable.
        tidenly 2y ago
        Sorry to rant a little, but as someone who grew up with HIV in the family, this odd pressure against people who might be hesitant to sleep with someone U=U always feels uncomfortable and manipulative to me. I see it a lot around the internet. The way I was raised, I'm the only person I trust with my sexual health. I would never trust someones word they're tested recently and have unprotected sex with them. I wouldn't trust someone saying they're on PrEP and have unprotected sex with them either. I can only trust myself. U=U is exactly the same situation. In a zero trust mindset like that, someone telling me they're U=U only tells me they have HIV. I have HIV+ friends who struggle to take their meds at the right time every day, or forget. And I also know people who have lied about when they last took their STI screening to hookups. I'm also sure a bunch of people would get angry if you asked a U=U person to show you their latest CD4 count or viral load proof too - so what am I to do, just trust that, unlike everyone else, U=U people are perfectly honest, and never screw up taking their meds? The response to this is often "anyone COULD have HIV, U=U people are actually safer because they have it locked down", but again to me this is about as trustworthy as "anyone COULD have HIV, but people on PrEP have it locked down". It all relies on the trust the other person is on top of their shit.
    - jsperx 2y ago
      This article from the NIH reviewing three large studies across heterosexual, bisexual and homosexual couples says the science is clear: https://www.nih.gov/news-events/news-releases/science-clear-hiv-undetectable-equals-untransmittable https://www.nih.gov/news-events/news-releases/science-clear-...
    - KennyBlanken 2y ago
      https://www.google.com/search?q=aids+tranmission+undetectable+level https://www.google.com/search?q=aids+tranmission+undetectabl...
jfengel 2y ago
Too bad it's so drastic. There's also a huge problem with autoimmune disorders, and it would be great to reboot them. Unfortunately you basically have to be near dead from leukemia before this procedure is reasonable.
nilsbunger 2y ago
I wonder if they can evolve this into an autologous stem cell transplant: take a patient's own bone marrow sample, do the genetic mutation, and insert it back? It avoids the graft-versus-host issues of using stem cells from another person, so it should be reasonably safe (though still a major procedure)
- jijijijij 2y ago
  > It avoids the graft-versus-host issues of using stem cells from another person Not sure that's the issues here. I think the major risk comes with completely wiping the original immune system, before implanting the new seed cells. Apart from the implications in any means of killing "half the body", people are existentially defenseless against any pathogen around them, for a few weeks. I think this procedure will never be reasonably safe, for anyone who isn't rolling their last die.
KennyBlanken 2y ago
Imagine how farther along we'd be on HIV treatment if we hadn't had someone in the White House who decided HIV was a 'gay people disease' and just shrugged. Every time I hear someone praise Reagan all I can think about is how sat on his hands and did nothing while a hundred thousand Americans died - 30,000 in the last year of his presidency alone - because of bigotry on the part of him and the Christian Right, who are still to this day screaming that LGBTQ people shouldn't have the same rights as everyone else.
- oofdoof 2y ago
  The people who use patriotism for every reason except actually caring for their fellow citizens.
- anjel 2y ago
  https://archive.is/20230318045621/https://www.politico.com/news/magazine/2022/05/27/gay-history-paranoia-conspiracy-reagan-kirchick-excerpt-00035193 https://archive.is/20230318045621/https://www.politico.com/n...
Samanthabontle 2y ago
[dead]
ImHereToVote 2y ago
Is there are reason bone marrow has to be inside bones. Couldn't you graft a bone marrow organ next to the liver or something?
jkljl 2y ago
[flagged]

169 points by belter 2y ago

deleted 2y ago

[deleted]

A 10% risk of death of a massive gamble compared to the alternatives. I can only hope this leads to a more useful solution than immune system replacement. I expect many would prefer a life of daily medication, or even shots every few months, which looks to be a promising form of treatment.

jfengel 2y ago
In this case there are no alternatives, because the patients have leukemia as well as HIV. For most people the current regimens for treating HIV are excellent. They can get the viral load down to undetectable levels, which makes it impossible to transmit. And the side effects are minimal.
- rvba 2y ago
  Are undetectable levels really impossible to transmit?
  - somnic 2y ago
    As I understand it, large studies of couples where one partner has HIV with an undetectable viral load and the other does not have HIV have not recorded any cases of transmission through sexual activity. The question of whether it's "impossible" or "extremely unlikely" comes down more to philosophy than anything pragmatic at this point. Transmission through sharing needles we have less confidence around, because illegal drug use is harder to study. IIRC not everyone reaches an undetectable viral load through antiretroviral medication, so you do need to make sure that's the case. Pre-exposure prophylaxis and general safe sex practices like condoms can mitigate the risk for people with low-but-detectable viral load and their partners.
    - pavlov 2y ago
      I grew up in the 1990s with an overwhelming fear of HIV as a teenager. It still feels incredible that the virus is now undetectable and non-transmissible with medication that’s not much of a burden in one’s daily life. A cure for AIDS was much closer than anyone imagined in 1993. When everything seems dark and hopeless, this is one of the examples that always lifts my spirits. Humankind can achieve incredible things together.
      - Gibbon1 2y ago
        While looking for something else on San Francisco's heath departments website I found the following two things. In San Francisco Deaths from AIDs dropped 70% from 1996 to 1997. That's in one year it went from a relentless death sentence to manageable chronic. While almost everyone that got HIV in the mid 80's are dead most people that got HIV in the mid 90's are still here. If that's not winning it's close.
        KennyBlanken 2y ago
        10,000 people a year die of AIDS in the US. Not even remotely close to "winning." I suspect a large portion of those deaths are due to poor sexual education thanks to christofascists, and people who don't get tested regularly because of poor access to family planning and reproductive health, again thanks to christofascists. All because Magical Sky God Said Abortion Bad. That and people who lose their healthcare and can't afford the meds because this country is the only developed nation in the world which does not treat healthcare like a universal human right, because corporations want to keep using health coverage to keep workers from switching jobs more freely, because they don't want a free labor market.
        mensetmanusman 2y ago
        It’s mostly through drug use, poverty, etc.
        rjzzleep 2y ago
        Isn’t that like a third of gun deaths in the USA? Personally for me this idea of trust that it’s undetectable and therefore non jtransmissible is not a risk I would recommend anyone to take, but at the same time we have to put things into relation no?
  - blue_dragon 2y ago
    My "pragmatic" analysis: I once spoke to a primary-care doctor about the risks of getting HIV through sex. The doctor told me that the risk of getting HIV the "typical way" (receiving anal sex) is about 1/72. Thus, for every 72 exposures, the recipient would contract HIV one time. This assumes that condoms are not used, and that the transmitter has an untreated HIV infection, which presumably has a high viral load. Transmission risk goes down by orders of magnitude for other forms of sex, until we get to receiving blowjobs, where the risk is literally nil. There are zero recorded cases of HIV caused by receiving a blowjob. In other words, HIV is actually kind of hard to get. You have to be very active, and not using protection, in order to get it. Or just be very, very unlucky. And that's with respect to untreated cases, which likely have high viral loads. This suggests to me that, for practical purposes, undetectable levels are impossible to transmit. Or as the Prep marketing executives would say, "U means U" - undetectable means untransmittable. Whether or not you're comfortable having sex with someone who is HIV+ but claims to have an undetectable viral load is a separate question entirely.
    - spencerchubb 2y ago
      > Whether or not you're comfortable having sex with someone who is HIV+ but claims to have an undetectable viral load is a separate question entirely. If someone has HIV, they would have to be extremely suicidal to forego taking the medication that would make them undetectable.
      - tidenly 2y ago
        Sorry to rant a little, but as someone who grew up with HIV in the family, this odd pressure against people who might be hesitant to sleep with someone U=U always feels uncomfortable and manipulative to me. I see it a lot around the internet. The way I was raised, I'm the only person I trust with my sexual health. I would never trust someones word they're tested recently and have unprotected sex with them. I wouldn't trust someone saying they're on PrEP and have unprotected sex with them either. I can only trust myself. U=U is exactly the same situation. In a zero trust mindset like that, someone telling me they're U=U only tells me they have HIV. I have HIV+ friends who struggle to take their meds at the right time every day, or forget. And I also know people who have lied about when they last took their STI screening to hookups. I'm also sure a bunch of people would get angry if you asked a U=U person to show you their latest CD4 count or viral load proof too - so what am I to do, just trust that, unlike everyone else, U=U people are perfectly honest, and never screw up taking their meds? The response to this is often "anyone COULD have HIV, U=U people are actually safer because they have it locked down", but again to me this is about as trustworthy as "anyone COULD have HIV, but people on PrEP have it locked down". It all relies on the trust the other person is on top of their shit.
  - jsperx 2y ago
    This article from the NIH reviewing three large studies across heterosexual, bisexual and homosexual couples says the science is clear: https://www.nih.gov/news-events/news-releases/science-clear-hiv-undetectable-equals-untransmittable https://www.nih.gov/news-events/news-releases/science-clear-...
  - KennyBlanken 2y ago
    https://www.google.com/search?q=aids+tranmission+undetectable+level https://www.google.com/search?q=aids+tranmission+undetectabl...

jfengel 2y ago

Too bad it's so drastic. There's also a huge problem with autoimmune disorders, and it would be great to reboot them. Unfortunately you basically have to be near dead from leukemia before this procedure is reasonable.

nilsbunger 2y ago

I wonder if they can evolve this into an autologous stem cell transplant: take a patient's own bone marrow sample, do the genetic mutation, and insert it back? It avoids the graft-versus-host issues of using stem cells from another person, so it should be reasonably safe (though still a major procedure)

jijijijij 2y ago
> It avoids the graft-versus-host issues of using stem cells from another person Not sure that's the issues here. I think the major risk comes with completely wiping the original immune system, before implanting the new seed cells. Apart from the implications in any means of killing "half the body", people are existentially defenseless against any pathogen around them, for a few weeks. I think this procedure will never be reasonably safe, for anyone who isn't rolling their last die.

KennyBlanken 2y ago

Imagine how farther along we'd be on HIV treatment if we hadn't had someone in the White House who decided HIV was a 'gay people disease' and just shrugged. Every time I hear someone praise Reagan all I can think about is how sat on his hands and did nothing while a hundred thousand Americans died - 30,000 in the last year of his presidency alone - because of bigotry on the part of him and the Christian Right, who are still to this day screaming that LGBTQ people shouldn't have the same rights as everyone else.

oofdoof 2y ago
The people who use patriotism for every reason except actually caring for their fellow citizens.
anjel 2y ago
https://archive.is/20230318045621/https://www.politico.com/news/magazine/2022/05/27/gay-history-paranoia-conspiracy-reagan-kirchick-excerpt-00035193 https://archive.is/20230318045621/https://www.politico.com/n...

Samanthabontle 2y ago

[dead]

ImHereToVote 2y ago

Is there are reason bone marrow has to be inside bones. Couldn't you graft a bone marrow organ next to the liver or something?

jkljl 2y ago

[flagged]