14 DAY TRIAL // German scientists at Charite-University Medicine in Berlin reported that they may have cured a man of HIV infection.
This announcement divided researchers into two camps: those optimistic about the whole thing and those saying that this method is not really worth it.
The study started three years ago, in February 2007, when an HIV-infected man, also suffering from acute myeloid leukemia (a cancer of the immune system), underwent a stem-cell transplant.
The patients stopped taking anti-HIV medication and the doctors wiped out his entire immune system though high doses of chemotherapy and radiation.
Thirteen months after the transplant the leukemia recidivated, so he underwent another round of treatment followed by another stem-cell transplant, from the same donor.
There is a catch however, since the donor's stem cells contained a rare, inherited gene mutation that made them naturally resistant to infection with HIV.
Still, study lead author Kristina Allers, said she was positive that HIV would nevertheless relapse over time.
Today, three-and-a-half years later, without taking any anti-HIV drugs, the patient presents no sign of either leukemia or HIV replication and his immune system has come back to normal.
So, the researchers thought it is safe to conclude that the “results strongly suggest that cure of HIV has been achieved in this patient.”
Nevertheless, Dr. Michael Saag, professor of medicine and director of the University of Alabama at Birmingham AIDS Center, said that “this probably is a cure, but it comes at a bit of a price.
“For him to receive the donor cells, his body had to have all of his immune system wiped out” and he received a bone marrow transplant.
“The Catch-22 here is that the best candidates for a cure, ideally, are people who are healthy” and don't suffer from leukemia.
CNN reports that in a telephone interview, Saag said that this treatment associated with wiping out the immune system “is very hazardous.
“Even if somebody doesn't die from a transplant, there are complications that make it very unpleasant for people to live with,” and in certain cases the transplant proves fatal.
The doctor added that this study actually proves the concept “that our understanding of HIV biology is correct, and that if you eliminate -- not just in theory but in practice -- all of the cells in the body that are producing HIV and replace them with uninfected cells, you have a cure.”
However, HIV-infected people can have a normal life span today, meaning that “a 25-year-old diagnosed today with HIV has a reasonably good chance of living to 80, 85, 90.”
Another factor that limits the popularity of this new method is money – the treatment costs hundreds of thousands of dollars for every person benefiting from it, and still, “it's not going to be applicable unless they develop leukemia or lymphoma and need a bone-marrow transplant,” added Saag.
The director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, said that this treatment is rather impractical.
He explained that “it's hard enough to get a good compatible match for a transplant like this.
“But you also have to find (a) compatible donor that has this genetic defect, and this defect is only found in 1% of the Caucasian population and 0% of the black population; this is very rare.”
This new study was published in the journal Blood.