Is the "Berlin Patient" No Longer Alone? Stem Cell Transplant Appears to Clear HIV in Two Men on Treatment
July 27, 2012
Two HIV-infected men are showing no traces of HIV in their blood after going through stem cell transplants similar to the one "Berlin Patient" Timothy Brown received, according to a study presented at the XIX International AIDS Conference.
The study results, discussed by Daniel Kuritzkes, M.D., from Brigham and Women's Hospital in Boston, showed a promising method of targeting the latent or hidden HIV reservoir.
Both patients underwent allogeneic (or foreign) stem cell transplantation for the treatment of lymphoma after being on antiretroviral therapy (ART) for about four years. The first patient was born with HIV and started ART three to four years before the transplant, while the second acquired HIV through sex in the mid '80s and started ART in 2003 before receiving a transplant in 2007.
Prior to the transplants, both men had undetectable viral loads, but still had HIV in hidden CD4 reservoirs. In contrast to Brown, they received a milder form of chemotherapy just before their transplants and were able to stay on HIV treatment throughout the transplant process.
While Brown's donor cells lacked the key CCR5 receptor, which HIV uses to attach to CD4 cells, the two men received donor cells that did have the CCR5 receptor and were fully susceptible to HIV. However, because they were able to remain on ART during the transplant period, the donor cells were not infected with HIV.
"We believe that continual administration of effective ART protected the donor cells from becoming HIV infected as those donor cells eliminated and replaced the patients' own immune cells, effectively clearing the virus from the patients' blood lymphocytes," Kuritzkes said.
One of the men has been followed for two years and the other for three and a half years. While both are still on HIV treatment, neither shows traces of HIV in their blood plasma and purified CD4 T cells using a sensitive culture method (less than 3 copies/ml). They are also showing a significant decline in HIV antibodies, suggesting a lack of HIV replication.
"The importance of our findings is that we have evidence now that we can protect uninfected cells from becoming infected when they're transplanted into an HIV-infected patient, a form of PrEP at the cellular level, if you will," Kuritzkes added.
The researchers plan on assessing the full extent of HIV reservoir reduction by looking for HIV in various body tissues and analyzing the effects of treatment interruption.
Warren Tong is the research editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
Copyright © 2012 Remedy Health Media, LLC. All rights reserved.
Comment by: Joost Br.
Thu., Aug. 9, 2012 at 4:46 pm EDT
Will never be a option for people with hiv, for 2 reasons, breaking down bodyresistance is a risk, finding stemcell donors with stemmcells who are not sensible for hiv is impossible for everyone even in western-europe and the USA. Hiv2 virus will be a major risk and hiv will become a poor people disease
Comment by: Mike
Thu., Aug. 9, 2012 at 3:09 pm EDT
If the effects of HIV meds were worse than the effect of untreated HIV, there would be no point to the meds. Before there were meds, everybody died. Remember?
Comment by: Rick
Wed., Aug. 8, 2012 at 5:53 pm EDT
This is so good to hear, I think we are really on our way to defeating this horrible disease for once!
Comment by: J
Tue., Aug. 7, 2012 at 9:16 am EDT
Do you know whether or not they received chemo due to having lymphoma or some other form of cancer?
Comment by: Antony E.
(W.yorks , UK)
Sun., Aug. 5, 2012 at 8:26 pm EDT
We need much more information on this topic including risk assessments - consistencies of such practices - how easy or not it is to find a match ANC Hos much this would costs and how long it may be before it can start being used on a regular basis
Ic also likd to know the expense do that we can work out Iv it's cost effective long term as supposed to just taking medications
Comment by: Dante D
Sat., Aug. 4, 2012 at 8:05 pm EDT
thats great news. I would love to be apart of this Doctor's future experimental studies.
Comment by: Paul
(Long Island, NY)
Thu., Aug. 2, 2012 at 10:46 pm EDT
I had recently seen a television interview with one of the doctors who had attended this recent AIDS conference. While he said that the research is promising, he alluded to some risks with the stem cell therapy. He didn't go into further detail. So I don't know what those risks might be. He also mentioned very high costs associated with the procedure and the difficulty of making it available on a large scale, especially in rural or less populated areas. Yes. It sounds hopeful. But I will feel more assured when my ID doctor recommends it for me. Until then, I'll remain on my meds and continue praying for quantum leaps in research and treatment. By all accounts, it's a miracle that I am still alive today. For this I am very thankful.
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Comment by: michael
Tue., Aug. 7, 2012 at 4:03 am EDT
amazing, isn't it? alluding to risks? there are risks to everything, even breathing. lol.
it's funny how many doctors shunned the doctor who cured (yes, cured)....why? because his discovery will put a lot fo them out of work. HIV is such a specialized field that a cure would be devastating to this niche in healthcare.
it all comes down to money and job security, not about saving lives. if it was, then there wouldn't be patents on medicines that could save millions.
this is also why stem cell research is being blocked at every level. it is a basic premise of repairing the body the way the body knows how to repair itself...with it;s own blank builkding blocks........stem cell research will lead to entire segments and fields in the health care industry being out of business. rich doctors and profitable pharmaceutical companies will go broke. there is no profit in cures that stem cell research will bring.
as far as risks to stem cell research, there are risks to everything.......the most obvious of all are the risks of ART and the side effects it has on our bodies. shame on that doctor. he of all people should know that there are risks to everything he does. his job is to find what's best for the patient by minimizing the risks, and not blurt out vague nonsense.
even now, there is technology to take a biopsy tissue sample from anyone, break it down into some type of centrifuge so that the tissue will become a form of blank stem cell raw material that can be implanted to the donor to parts of his organs that needs repair. the newly balnk stem cell will mimic the organ tissue that needs repair and takes the place of the damaged cells.
Comment by: Bill
Tue., Aug. 7, 2012 at 11:59 am EDT
For more info on Allogenic Stem Cell Transplant, search the web. U will see that there are many risk factors in a HSCT. It's not a walk in the park. Many things can and do go wrong during a HSCT (outside the realm of HIV)that lead to a poor outcome(death). Finding a donor match is difficult at best even if you have siblings. The cost for HSCT is astronomica and at this point, I personally feel the medical professionals are still experimenting with all forms of HSCT.I lost my partner to an autogolous SCT (this procedure uses your own stem cells as opposed to a donors) 18 months ago. He under went the autogolous SCT for relapsed HL cancer. The odds of survival for this type of HSCT are 50/50...not real good when your betting with your own life. And by the way, the Transplant Team Doc’s at Moffit National Cancer Center in Tampa, FL never indicated that there was a 50/50 chance of survival, even after posing this question to them. Their response when asked was that he had a 50% chance that his HL would never relapse again as opposed to an almost 100% chance that the HL would reoccur with just standard chemo. Skillfully they avoided the appropriate response. At best guess they said with just standard chemo he would relapse again in approx. 5yrs (half the time that it took him to relapse from being in remission for 10 yrs after his first chemotherapy). I would trade the certainty of a relapse to the 50/50 transplant survival odd. I'd still have him now. But who knew…that was never explained by the Doc’s. Bottom line: YOU must be your own medical advocate...read, read, read and ask, ask, and demand definitive answers to your questions from your Doc's. Wish I had done this…my(our)lack of due diligence has cost us dearly.
Comment by: Rick
Wed., Aug. 8, 2012 at 5:59 pm EDT
This just goes to show you that not EVERYONE is into the all mighty Dollar.... There are some great doctors who STILL believe in CURE research, And we will have a cure!
Comment by: James
Thu., Aug. 2, 2012 at 4:50 pm EDT
Thank you, Warren, for this most interesting report. It is so good to hear of any slight progress! A fragment of good news is far better than none.
And thank you too for including the link to the abstract at http://pag.aids2012.org/Abstracts.aspx?SID=274&AID=6016. I found that reading the abstract and your interpretation of it most informative.
May all the good people in white coats keep beavering away at this challenge until they crack it and provide us with a cure! I am desperate to get off these toxic drugs that I've been taking for about ten years now and which continue to wreak very unpleasant side-effects on my brain and body. I do not exaggerate when I say that I don't know how long I want to go on like this. I regularly think of calling it quits and arranging an early death.
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Comment by: michael
Sat., Aug. 4, 2012 at 4:11 am EDT
i know what you mean. it irks me how many articles and studies scolds hiv patients for missing their meds. let them take the meds for several years and see how it interferes with your body as much as the virus does, if not more.
the reason these meds cause diarrhea is because diarrhea is the body's natural reaction and trigger for expelkling toxicity from the body...that alone is a big indication of how much stress your body goes through taking the meds....not the mention how it slows cognitive functions, among other things.
i've bee undetectable for a few years, and though many physicians may not like it, i make it a point to take a one day holiday every two weeks from my meds just so i can feel "normal" again. those two days out of the month, my body feels "normal" and plan those days doing things i use to do before the disease....
these cookie cutter approach to meds, a one dosage fits all approach is disheartening. i am a man but not a very heavy man. i've always been skinny all my life. for me to take the same dosage regardless of built and weight, i don't believe" is ideal because it feels it i'm overdosing my body with ART everyday, poisoning it to an extent. it makes no sense that a 140 lb man would tolerate the same amount of meds that a 250 lb man would, especially drugs as toxic as ART. same case goes for women.
HIV cure was never a priority in this country. if it was, then these so called miracle drugs that prolong life would be easily available and affordable....not patented ebyond the affordability of the average person who needs them.
Comment by: Jim Vokoun-Robinson
Wed., Aug. 1, 2012 at 7:58 am EDT
This is a highly misleading article. These two men did NOT get a stem cell transplant similar to Timothy Brown. These two men MUST continue to take HIV medications for the rest of their lives. This is NOT a cure, and I am very tired of seeing irresponsible reportage, over and over again.
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Comment by: Warren
Wed., Aug. 1, 2012 at 5:18 pm EDT
Thank you for your comment. But I must clarify that the two men did receive stem cell transplants, which were similar to Timothy Brown's in that their original HIV-infected CD4 cells were replaced by the donor's HIV-negative cells. I did note that their donors did not have the CCR5 mutation that Brown's donor did. So while it is not the same as Brown's, it is similar.
I also noted that the two men are still taking treatment, but we still don't know if they "must continue to take HIV medications for the rest of their lives," or if their CD4 cells are indeed HIV negative, which given their latest tests seem to be the case. we won't know until the researchers attempt treatment interruption.
And if it turns out that they are actually HIV negative now, they would still be able to contract HIV because their new cells have the CCR5 receptor. Either way, I reported the facts from the study and never called it a cure.
Comment by: Chrissy
Mon., Aug. 13, 2012 at 9:34 am EDT
I think the point of this article is to show that we are advancing in research and a POSSIBLE cure. There is nothing in the article that gives false information about this procedure being a true cure....but only that a breakthrough has been made and this is something that needs to be studied further.
Comment by: Joel A.
Tue., Sep. 4, 2012 at 5:55 pm EDT
yeahhhh buddy, keep your opinion to yourself. thanks.
Comment by: Jose
Wed., Sep. 5, 2012 at 5:17 pm EDT
were you there? do you know all the facts? no, obviously the people who did the article know alot more than you do, and your just jelous.
Comment by: michael
Tue., Jul. 31, 2012 at 6:00 am EDT
hmmmm.....this is really very interesting and again, like the berlin patientm, very surprised that this is not breaking news for the media.
significant declines in hiv antibodies? by how much? the most fascinating thing is that donor cells had the ccr5. if ART has the virus in check, it protects new cd4 cells, therefore, possibly exhausting the existing hiv to replicate itself to death if the stem cells produced fresh cd4 to combat the virus.
koronis pharma had thsi approach in mind, that you can have hiv self replicate itself to death, since like most things, it can only multiply itself a certain amount of time before it dies. so if no new virus exist due to being controlled by ART, then the old virus and old CD4's infected replicates itself to death and the body will be replenished by new CD4's by the stem cell research.
this is big. an approach to control replication and exhausting existing infected CD4 cells while replenishing the body with new CD4's with stem cell transplants.......
now it's just a matter of timing the longevity of the infected cells. if there is a way to force it to increase its replication frequency so that the hiv life span will end sooner and self destruct, per se.
cure can be achieved within a few years of this approach in therapy. just a matter of increasing the replication speed of infected CD4's while ART protects non infected or newly introduced CD4's from being infected. of course, it would work better if the new cells had no ccr5 receptors so the virus would not have anything to latch on to, but if ARt is potent enough, it might not be needed.
Comment by: Xavier
Sat., Jul. 28, 2012 at 7:17 pm EDT
I would be curious to know, if these patients were on the same ART drugs, or if they were both on different ARTs. I recenty read truvada might become a drug of choice to at risk people of getting HIV, to help them prevent getting HIV.
Comment by: Jose
Fri., Jul. 27, 2012 at 8:41 pm EDT
Please GOD let this be it
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