Therapy may cure patient, 42, with AIDS
11/13/2008BERLIN - 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 said yesterday.
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 2 million lives each 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," Dr. 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 have all been clean.
However, Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., said those tests probably have not been extensive enough.
"A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Dr. Badley said.
This isn't the first time marrow transplants have been attempted for treating AIDS or HIV infection. 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.
Dr. Huetter's patient was under treatment at Charite for AIDS and leukemia, which developed unrelated to HIV.
As Dr. Huetter - who is a hematologist, 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.
Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United States, said it helps prove the concept that if you can block CCR5, doctors might be able to inhibit the ability of the virus to replicate.