Man unexpectedly cured of HIV after stem cell transplant

Haven’t they done exactly this several times already?

Edit: Yep.

https://www.nature.com/articles/d41586-024-02463-w

It’s happened at least 5 times.

	▲	helsinkiandrew an hour ago \| parent [-]
		The novelty of this (not captured in the headline) is that the man received non-resistant stem cells . I believe in all previous cases the donors had mutations of the CCR5 gene which made them resistant to HIV.

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krylon 3 hours ago | parent | prev | next [-]

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.

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helsinkiandrew an hour ago | parent | next [-]

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

[1] https://www.nbcnews.com/health/health-news/7th-person-hiv-cu...

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rsynnott 2 hours ago | parent | prev [-]

> I don't think this is the breakthrough

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.

	▲	gpjt an hour ago \| parent [-]
		How much of that low survival rate is due to the condition they received the transplant, though? Conceivably a patient with "just" HIV might do better than one with eg. leukemia and HIV. That said, IIUC the whole stem cell transplant procedure is unpleasant enough that it still might not be worth it.

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didgeoridoo 2 hours ago | parent | prev | next [-]

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.

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helsinkiandrew an hour ago | parent | prev | next [-]

https://archive.ph/8e3sM

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Traubenfuchs 3 hours ago | parent | prev | next [-]

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.

	▲	francisofascii an hour ago \| parent [-]
		This is the 7th case, so this seems like a bigger puzzle piece.

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brador an hour ago | parent | prev | next [-]

How long before people find out the real source of stem cells.

Will they care?

Or will they throw it in the bucket with the cobalt mines.

	▲	idiotsecant an hour ago \| parent [-]
		three to five-day-old blastocysts and adult bone marrow? Oh wow it's a lot less ominous if you just say it out loud instead of hiding behind your cape and making spooky noises huh.

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fithisux 3 hours ago | parent | prev [-]

I think this is random.

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bilekas an hour ago | parent [-]

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.

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fithisux 34 minutes ago | parent [-]

My take is that this is a discovery by luck.

i am not a doctor but maybe the stem cell transplant just removed something dormant.

But needing a cell transplant to remove the HIV sounds inhuman to me. It is an intervention but I am not convinced you need all this pain to cure him from HIV.

Was he already on antiviral drugs? I think so.

Also the subtitle of the article is pretty revealing

"A handful of people with HIV have been cured after receiving HIV-resistant stem cells – but a man who received non-resistant stem cells is also now HIV-free"

HN has become downvoting machine. So sad. I wonder how many people could have been cured from their malladies if people were less aggressive.

	▲	bilekas 25 minutes ago \| parent [-]
		> HN has become downvoting machine. You could have mentioned what you just have in your original answer, your original answer would be more suited to facebook, so it's considered low quality, so it's down voted, don't take it personally. > Was he already on antiviral drugs? I think so. The article is focusing on the surprise that the cells did NOT contain the CCR5 mutation. When they we confident this was a key factor in curing patients. > was declared free of the virus for more than two years after receiving stem cells without the CCR5 mutation, suggesting CCR5 isn’t the whole story > It is an intervention but I am not convinced you need all this pain to cure him from HIV. Again you're making this broad statement as you have some insight into the matter, I don't know about it, the doctors who do seems to have admited they're still learning things. Thats the nice thing about this article. More places to sudy and research.