Marrow transplant 'may have' cured AIDS
AP © [Enlarge photo]
An American man who suffered from AIDS appears to have been cured of the
disease 20 months after receiving a targeted bone marrow transplant normally
used to fight leukemia, his doctors say.
While researchers - and the doctors themselves - caution that the case might be
no more than a fluke, others say it may inspire a greater interest in gene
therapy to fight the disease that claims two million lives a year. The virus
has infected 33 million people worldwide.
Dr Gero Huetter said his 42-year-old patient, an American living in Berlin who
was not identified, had been infected with the AIDS virus for more than a
decade. But 20 months after undergoing a transplant of genetically selected
bone marrow, he no longer shows signs of carrying the virus.
"We waited every day for a bad reading," Huetter said.
It has not come. Researchers at Berlin's Charite hospital and medical school
say tests on his bone marrow, blood and other organ tissues showed no signs of
AIDS.
However, Dr Andrew Badley, director of the HIV and immunology research lab at
the Mayo Clinic said those tests were probably not extensive enough.
"A lot more scrutiny from a lot of different biological samples would be
required to say it's not present," Badley said.
Marrow transplants have been used before to treat AIDS or HIV.
In 1999, an article in the journal Medical Hypotheses reviewed the results of
32 attempts reported between 1982 and 1996. In two cases, HIV was apparently
eradicated, the review reported.
Huetter's patient was under treatment at Charite for both AIDS and leukemia,
which developed unrelated to HIV.
As Huetter - who is a haematologist, not an HIV specialist - prepared to treat
the patient's leukemia with a bone marrow transplant, he recalled that some
people carry a genetic mutation that seems to make them resistant to HIV
infection. If the mutation, called Delta 32, is inherited from both parents, it
prevents HIV from attaching itself to cells by blocking CCR5, a receptor that
acts as a kind of gateway.
"I read it in 1996, coincidentally," Huetter told reporters at the medical
school. "I remembered it and thought it might work."
Roughly one in 1,000 Europeans and Americans have inherited the mutation from
both parents, and Huetter set out to find one such person among donors that
matched the patient's marrow type. Out of a pool of 80 suitable donors, the
61st person tested carried the proper mutation.
Before the transplant, the patient endured powerful drugs and radiation to kill
off his own infected bone marrow cells and disable his immune system - a
treatment fatal to between 20 and 30 per cent of recipients.
He was also taken off the potent drugs used to treat his AIDS. Huetter's team
feared that the drugs might interfere with the new marrow cells. They risked
lowering his defences in the hopes that the new, mutated cells would reject the
virus on their own.
Anthony Fauci, director of the National Institute of Allergy and Infections
Diseases in the US, said the procedure was too costly and too dangerous to
employ as a first line cure. But he said it could inspire researchers to pursue
gene therapy as a means to block or suppress HIV.
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