Bone marrow offers hope for HIV patients

[WillieW]

http://www.medicalnewstoday.com/articles/145027.php


Bone Marrow Transplant May Offer A Revolutionary New Direction For HIV Therapy
Main Category: HIV / AIDS
Article Date: 05 Apr 2009 - 2:00 PDT

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Doctors in Germany have successfully controlled HIV infection by transplanting bone marrow cells from an HIV-resistant donor. This extraordinary case has important implications for the future treatment of HIV, a disease that kills millions each year.

Globally, 33 million people are living with HIV and the condition causes 2 million deaths each year. Although HIV-infected people are living longer than ever before because of modern drug therapy, these drugs are costly and limited by side effects and the development of resistance in HIV. Crucially, drug therapy suppresses the infection but does not offer a cure.

Speaking at the 35th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT), Professor Eckhard Thiel (Department of Hematology, Oncology and Transfusion Medicine, Charité University Hospital, Berlin, Germany) reported that the transplantation of stem cells from people who are naturally resistant to HIV could offer a new direction in HIV research and therapy.

In order to infect human cells, HIV must interact with two receptors on the cell surface: one is called CD4 and the second is usually one called CCR5. About 1-3 in a hundred people do not express these CCR5 receptors owing to a genetic abnormality (called a 'homozygous CCR5 delta32 deletion'). These people are naturally highly resistant to HIV infection because the virus cannot enter their cells.

Professor Thiel and his colleagues used a novel procedure to treat a 40-year-old HIV-infected man with acute myeloid leukaemia, a form of cancer of the bone marrow and white blood cells. When chemotherapy failed to control the leukaemia, the patient received two bone marrow stem cell transplants from a donor. Although these transplants are an established treatment for leukaemia, this donor was deliberately screened for the CCR5 HIV resistance gene.

Two years after the first transplant the patient is still free of the cancer and - remarkably - the HIV infection. No trace of the virus can be found in his bloodstream or in other areas of the body where HIV can lie dormant, such as the gut and the brain. His blood and marrow cells have all converted to the CCR5-free, HIV-resistant type and the infection-fighting blood cells that HIV normally destroys (called CD4 T cells) have returned to normal levels. The patient has not needed any HIV drug therapy since his first transplant, and will not need it again as long as HIV remains undetectable.

Stem cell transplantation from resistant donors will not be available for the majority

[pinto]

1. An extraordinary case. Hopefully the research accompanying this procedure

will result in some more broadly available therapies aimed at the CCR5 receptors. :thumbsup: