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Monday 21st May 2018

Bone marrow 'cured' AIDS patient

17th November 2008

A bone transplant given to a man at a Berlin hospital two years ago appears to have cured him of both HIV and leukaemia, doctors said.


The bone marrow given to the patient, a US national living in Germany, was of a type that had a genetic resistance to HIV.

The 42-year-old man, who had been HIV-positive for about a decade, attended the Charite university clinic three years ago suffering from leukaemia, for which he had received treatments including chemotherapy.

Charite professor Rodolf Tauber, called for further research before any conclusions were drawn about bone transplants and HIV.

In a statement he said it would not be right to promise the millions of people infected with HIV worldwide that there was hope of a cure.

The doctors in the clinic used opportunistically marrow from a donor which also happened to contain a genetic variant known to offer some protection against HIV. It is a mutation which occurs in 1-3% of the European population.

The mutation, known as Delta 32, in a gene called CCR5 on Chromosome 3, works by reducing the number of docking points on the surface of T cells, key parts of the immune system.

This lowers the risk of cell penetration by the pathogen. The donor in this case had inherited a copy of of the gene from his mother and his father, giving him a double copy.

During the process, the patient stopped taking his HIV medication. Usually, a sharp increase in levels of HIV would be seen in a short time, but there was still no sign of HIV in the man, more than 20 months after the transplant.

But Charite medical team member Gero Huetter warned that the process was not adapted for the treatment of patients with HIV, neither today nor in the near future, warning against false hopes.

Since first coming to light in 1981 among young homosexuals in California, HIV/AIDS has killed at least 25 million people. A further 33 million people are living with HIV worldwide.

The Berlin case may have prevented the virus from 'holing up' in dormant memory T cells in lymph nodes in the body, which it has been shown to do when the patient is successfully taking antiretroviral therapy. It reemerges if treatment is stopped.

Roughly one in 1,000 Europeans and Americans have the inherited genetic mutation.

Experts said they were surprised no-one had tried a bone marrow transplant of this kind before.

Professor Andrew Sewell, from the Department of Medical Biochemistry and Immunology at the University of Cardiff said in theory a bone marrow transplant such as this one "should work".

However, such a procedure would be beyond the reach of most people living with HIV, who are in poverty-stricken regions of sub-Saharan Africa.

Gene therapy that knocked out the mutation of the key CCR receptor could pave the way for future treatments, Sewell added.

But AIDS NGOs said the treatment would certainly not offer a quick fix, and that prevention was still the number one priority.


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