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Comment by carbocation | Hacker News Reader

This isn't all that surprising given that they did not receive special bone marrow, but it is very sad for these patients.

<speculation>Even in the Berlin patient, it is likely that there is some reservoir of HIV+ cells, but because his transplanted bone marrow lacks the CCR5 receptor, that reservoir cannot expand, so he appears cured (and, for all purposes, is).</speculation>

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The viral reservoir of the Berlin patient has been examined and it is competent for X4 tropism. The fact that the virus has not re-infected cells (via the CXCR4 receptor) is some combination of factors/luck that we do not understand fully. The leading hypothesis is that the number of X4 tropic infectious particles are simply too low to reseed the replaced immune system.

For background I recommend the original studies of this patient (Hutter 2009, NEJM and Allers 2011, Blood), they contain a wealth of interesting information.

well then it seems the faulty assumption is that the HIV virus in his body only can attach to the CCR5 receptor, when what is likely is that some nonzero pool of virus has mutated to attach to another receptor altogether or have slightly less affinity to CCR5 but a hybrid affinity with another receptor.

These virii will then have the capability of hiding in a different cell type from immune cells, and come back later.

I think there is some confusion. The Berlin patient, the one who was transplanted with CCR5-negative donor stem cells, is still cured. Therefore, none of that explanation is needed.

thanks carbocation. Strangely enough, I remember you from the chembark days. You should check out what I'm doing (see profile).

Awesome; I see http://www.indysci.org/projectmarilyn/ from your profile. Looks like your fundraising starts tomorrow? I hope everything goes well. What you're embarking on has probably not been tried before and will be very interesting, so please keep us posted.

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