HIV appears cured after stem cell transplant | Hacker News Reader

HIV appears cured after stem cell transplant

cnn.com

42 pointsdcurtis12 comments

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

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

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

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

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

This lends a lot more credibility to the news.

This new article is also very misleading with it's inclusion of 'stem cells'. They did a bone marrow transplant, not a stem cell transplant. While there are stem cells (not embryonic stem cells) in bone marrow, calling it a stem cell transplant is incorrect.

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

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

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

Good Luck

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

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

  Sounds like this isn't really big news at all ... Or am I too skeptical?

It does seem harder to trust a news source these days for accurate news, but as far as one thing that worked once being news or not: isn't that one definition of what "news" used to be? The discovery of the first _____.

I think it's big news. (Possibly) curing HIV in one patient is better than zero patients, so it's a step forward. Given that this line of attack has been shown to work, follow on research might develop something less risky like a gene therapy or something (IANAD, so what I said might sound extremely stupid to those who are).

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

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

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

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

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

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

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

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

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

Reply on news.ycombinator.com