2 Cured?

Doctors reported today that two patients with HIV, now have no trace of the virus in their systems and haven’t required their HIV medication for several weeks. The patients have undergone stem cell transplants as treatment for cancer. Doctors warn that it is still too early to say that the patients were definitively cured but they have only been off their treatments for 15 weeks and seven weeks, respectively.

Dr. Timothy Henrich of Harvard Medical School and Brigham and Women’s Hospital in Boston led the research. The findings were reported at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. Henrich said at the conference “they are doing very well” when asked about the patients. “While these results are exciting, they do not yet indicate that the men have been cured. Only time will tell.”

However the initial news brought hope to many suffering with aids.

Henrich reported that the 2 men had been taking antiretroviral medication for their condition but they developed Hodgkin’s lymphoma and underwent chemotherapy as well as stem cell transplants while still receiving their antiretroviral medication. the men received their transplants at different times; one nearly three years ago and the other four-and-a-half years ago. The virus is now undetectable.

Is the HIV virus just hiding undetected elsewhere in the body or is it gone? The Associated Press reported that more time is needed to determine the answer. Doctors will have to continue monitoring the patients because it may take more than a year to make sure viral rebound does not occur according to Dr. Robert Siciliano of Johns Hopkins University.

Last year at the 2012 International AIDS Conference we first learned of these two men. They had not yet been taken off antiretroviral medications but even then the HIV level in their blood was undetectable. This brings new hope to those effected by this epidemic as well as those studying it.

 

Such news is great, particularly for those of us who remember the fear surrounding HIV thirty or more years ago. Back in the earlier days, I was working in a hospital, overseeing procurement of janitorial supplies. This was before one could just go online and research those cleaning products that are required for contaminated work environments. Clean and sanitary work environments to prevent contact with blood or bloodborne pathogens is standard today. OSHA is very particular in their recommendations. Interestingly, products registered by the EPA as HIV effective are not necessarily effective against tuberculosis (tuberculocidal) or against the hepatitis B virus (HBV). Today one can check the approved EPA’s registered disinfectants and then search online for where one can purchase them. Just like the consumer today who does a search, for instance, for eco friendly janitorial supplies, compare prices and then purchase. In my former job at a hospital we had recommendations of the best disinfectants against tuberculosis (tuberculocidal), but were in unknown territory when it came to HIV-1 or HBV. Now hospitals follow strict EPA, OSHA, as well as federal, state, or local regulations. However, as we learned in the recent Ebola crisis, even with all those regulations in place, error on the side of properly education hospital staff can still result in contamination.

Timothy Brown (A.K.A. the Berlin Patient) underwent stem cell transplantation as part of his treatment protocol for leukemia. He later became the first person deemed “cured” of HIV. In Brown’s case, the stem cells transplanted into him were HIV-resistant stem cells. Henrich and his team took a similar approach but in the cases of these two men, the stem cells did not have that genetic mutation for HIV resistance. A more intensive chemotherapy regimen was also assigned to Brown.

Stem cell transplantation is likely to be unfeasible for most HIV-positive people. The reason why the approach seemed to work for these men is because they had certain gene mutations that made their immune system cells resistant to HIV infection. In general, bone marrow transplants are very expensive procedures with a 15 percent fatality rate.

This is just one of the latest HIV treatment breakthroughs that have been reported as of late. A baby born with HIV was given faster, stronger-than-usual treatment immediately upon birth, even before doctors were able to test that the baby actually was infected with HIV. The child was last reported as being 2.5 years old and not needing to take antiretroviral medication for a year.

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