Well that's a take, would you like to share whatever insights you have into that ?
I think I would be more surprised than anything else if it was random because I'm not sure I've ever heard of someone 'randomly' being cured of any disease without intervention.
People have to understand that individual cases of effectively curing HIV via stem cell transplants are merely providing a few puzzle pieces to HIV research, if at all, but have no clinical applicability, as a stem cell transplant is always an extreme, dangerous and last-resort treatment for otherwise unmanageable diseases, as which HIV generally does not count anymore.
People also have to understand that some weapons are useful having just in case, and that we might be a few mutations away from HIV becoming unmanageable again.
I vaguely recall there was a case a few years back where a patient had been cured of HIV. But they had effectively their entire immune system wiped out by radiation therapy or something along those lines, and then received a bone marrow transplant from a healthy donor. So not something that could easily be replicated in many patients.
Still, that is big news, considering how many people have died from HIV, and how many still live with the virus. Treatment has come a long way - I remember how it was practically a death penalty in the 1990s; but a complete cure would be so much better than depending on medication for the rest of one's life. I don't think this is the breakthrough, but it is proof that search for a cure is not futile.
Definitely not. Five year survival rate for stem cell transplants is about 50%. People with HIV now have effectively normal life expectancies provided that they're treated. Even if this worked reliably, it would be _very_ much a case of the cure being worse than the disease.
I think its been done a few times [1]. Crudely put: try to wipe out as much of the immune system then replace with stem cells from a donor. Previously they used donors who had a gene mutation that made them HIV resistant, but this was with 'normal' genes. But a stem cell transplant may have worse survivability than HIV for many people
I know what you were getting at but I think it’s important to point out that people don’t actually die from HIV they die from AIDS which is caused by HIV.
There is at least one documented case of someone using anti-retroviral therapy, getting their viral load down to undetectable, stopping the therapy and remaining undetectable for years without continued therapy. They use the word "remission" rather than "cure" because there are fragments of viral dna that remain in your cells and it's possible for a "reservoir" of inactive virus to exist and activate, so there will always be regular testing involved in any attempt to eliminate the virus entirely, but whether it technically counts as "cured" becomes a nearly-moot point when one is able to live the same way that someone who has never been exposed lives save for the testing.
If I’m reading this correctly it sounds like it might a kind of beneficial graft-vs-host reaction?
The HIV-free transplanted immune system sees the original immune system as alien, and proceeds to wipe it out at the cellular level. This presumably takes the HIV with it, even if the new immune system is not itself resistant.
I guess this means that quiescent HIV is not at a stage in its lifecycle where it can reinfect cells if its host cell is destroyed. My hilarious mental model of infectious HIV virions floating inside a CD4+ T-cell like angry bees inside a balloon is clearly mistaken.
My sister in law has a stem cell transplant under this team https://sheffield.ac.uk/neuroscience-institute/research/brea... for Multiple Sclerosis. It was a small multi-country trial of about 100 people, I recall. This was nine years ago and she counts herself as cured, though to has a follow up once a year with the same team. The treatment is expensive, and though this was all UK National-Health-Service linked, the NHS is seeking cheaper MS treatments now: https://www.mssociety.org.uk/research/latest-research/latest... (Metformin, ALA, ?) There was a trial before this trial - some 20 people in Canada (?) and a couple died. In the 100 person trial they changed the selection criteria for patients, and I'd like to think nobody died cos of the treatment, but I've not heard anything to be able to add a figure. Its Mexico only now perhaps, people did self-fund to go to Moscow for the same treatment: https://www.bbc.co.uk/news/uk-scotland-54560236. These two ladies are not updating how it went for them, years later, but one is on Instagram living a normal life, and the other Facebook
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[ 2.6 ms ] story [ 49.2 ms ] threadI think I would be more surprised than anything else if it was random because I'm not sure I've ever heard of someone 'randomly' being cured of any disease without intervention.
Still, that is big news, considering how many people have died from HIV, and how many still live with the virus. Treatment has come a long way - I remember how it was practically a death penalty in the 1990s; but a complete cure would be so much better than depending on medication for the rest of one's life. I don't think this is the breakthrough, but it is proof that search for a cure is not futile.
Definitely not. Five year survival rate for stem cell transplants is about 50%. People with HIV now have effectively normal life expectancies provided that they're treated. Even if this worked reliably, it would be _very_ much a case of the cure being worse than the disease.
[1] https://www.nbcnews.com/health/health-news/7th-person-hiv-cu...
There is at least one documented case of someone using anti-retroviral therapy, getting their viral load down to undetectable, stopping the therapy and remaining undetectable for years without continued therapy. They use the word "remission" rather than "cure" because there are fragments of viral dna that remain in your cells and it's possible for a "reservoir" of inactive virus to exist and activate, so there will always be regular testing involved in any attempt to eliminate the virus entirely, but whether it technically counts as "cured" becomes a nearly-moot point when one is able to live the same way that someone who has never been exposed lives save for the testing.
The HIV-free transplanted immune system sees the original immune system as alien, and proceeds to wipe it out at the cellular level. This presumably takes the HIV with it, even if the new immune system is not itself resistant.
I guess this means that quiescent HIV is not at a stage in its lifecycle where it can reinfect cells if its host cell is destroyed. My hilarious mental model of infectious HIV virions floating inside a CD4+ T-cell like angry bees inside a balloon is clearly mistaken.
Edit: Yep.
https://www.nature.com/articles/d41586-024-02463-w
It’s happened at least 5 times.