Two patients off antiretrovirals-- WHAT DOES IT MEAN??

Over 9000 emails about this bit of news:

Bone marrow 'frees men of HIV drugs'

I actually wrote about this duo almost exactly a year ago. If you want to know more about the science of what is going on, click here:

Two more HIV-1 patients kind of sort of cured-ish maybe

The only new bit to add to the post from a year ago is this:

One has gone 15 weeks, and the other seven, since stopping treatment, and no signs of the virus have been detected so far.

So quick recap for those of you with an aversion to clicking links because I just embed things for fun-- Two patients had been living with HIV for a long time. They got blood cancers. The cancers were killing them, so they needed bone marrow transplants. During treatment (theoretically killing most of the HIV infected cells, along with the cancer cells), they stayed on their antiretrovirals (not standard therapy). The virus did not rebound, in, apparently a year.

So they went off the drugs.

And there is no detectable virus.

Yet.

There are still some possibilities keeping physicians and HIV scientists from using the word 'cure'--

  1. There might still be some latent HIV. When it is silent, we cant see it. We have no way of knowing whether there is a little ticking time-bomb hiding deep in some tissue.
  2. There might be low levels of replication hiding somewhere. While our methods for detecting HIV are sensitive, they are not perfect. If there is a slow replicating virus (a variant that was resistant to the antiretroviral therapy would, traditionally, be rather slow replicators) in a pocket in say, the brain, we wouldnt necessarily be able to detect it.

This is still, a year later, just me just guessing from press releases and random quotes in articles-- there is no actual publication for us to read yet.

So my conclusion this year is the same as it was last year:

This might be GREAT news for some patients, and a functionally useless development for most.  But no doubt about it, its pretty damn awesome for at least two people.

 

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Does this also use bone marrow from HIV-resistant donors, or is that a separate bone-marrow transplant 'cure'?

By Blaise Pascal (not verified) on 07 Jul 2013 #permalink

Nope-- Totally 'normal' bone marrow. The 'trick' was keeping the patients on antiretrovirals during treatment. Kill as many targets as possible, protect the new targets with antiretrovirals. Looks like it worked for these two patients, so far...

Do the antiretrovirals have any major bad side-effects? Is there any reason to not make continuing the antiretroviral therapy standard procedure?

By Blaise Pascal (not verified) on 07 Jul 2013 #permalink