I've had an allogenic stem cell transplant. It was hell. I no longer have cancer, so it was worth it. But HIV/AIDS (with standard treatment and testing) no longer significantly reduces life expectancy.<p>I have a hard time imagining a future where allogenic stem cell transplants are used to treat HIV. The procedures are incredibly risky and carry long term consequences (and in many cases, like mine, also unbearably painful for weeks).<p>To me, the most likely practical consequence of these findings is to spur on interest in using CRISPR (or other in-vivo genetic modification strategies) to alter the genome of an HIV patient to be "immune" to HIV. (A similar idea is used in treatment of some blood cancers. Chase the rabbit-hole of "CAR T Cell therapy" to get started.)
Not endorsing the credibility of this article, but if you think this is interesting, you'll likely think <a href="https://www.variantbio.com" rel="nofollow">https://www.variantbio.com</a> is awesome.<p>They scour the globe looking for people groups, families, regions, etc. that have extremely rare immunities and other outlier characteristics in order to sequence their DNA.
> The stem cell transplantation is a complicated procedure that comes with many risks, and it is too risky to offer it as a cure for everyone with HIV.<p>Maybe it's just me but I hate when people/articles generalize like this. What are the risks? What are the benefits? What is the SPECIFIC hazard to health that is occurring? They just stick to general statements, because, in my opinion, they don't want to do the research. Either way the news itself is good to hear.
<i>All four of these patients had undergone stem cell transplants for their blood cancer treatment. Their donors also had the same HIV-resistant mutation that deletes a protein called CCR5, which HIV normally uses to enter the cell. Only 1% of the total population carries this genetic mutation that makes them resistant to HIV.</i><p>The article is horribly wrong about CCR5 being the only pathway of the HI Virus to infect your cells and ultimately cause AIDS.<p><i>A problem of this approach is that, while CCR5 is the major co-receptor by which HIV infects cells, it is not the only such co-receptor. It is possible that under selective pressure HIV will evolve to use another co-receptor.</i> [1]<p>Why this treatment still worked is because:<p><i>However, examination of viral resistance to AD101, molecular antagonist of CCR5, indicated that resistant viruses did not switch to another co-receptor (CXCR4), but persisted in using CCR5: they either bound to alternative domains of CCR5 or to the receptor at a higher affinity. However, because there is still another co-receptor available, it is probable that lacking the CCR5 gene does not make one immune to the virus; it would simply be more challenging for the individual to contract it.</i> [1]<p>So a mixture of anti-retroviral treatments, which suppress the HIV replication to a point of not showing up in PCR tests anymore (while taking the medication), and (partially?) inhibiting the remaining viruses from infecting cells via the CCR5 pathway, further limiting their replication, caused these patients to be cured.<p>I don't know if the replication slowed down so much that their body was able to kick HIV out once and for all, or blocked it outright because the already reduced number of viruses simply could not beat the odds of infecting via a alternative pathway. Kudos to the researchers!<p>Why is this important: The CRISPR babies[2] had this exact gene removed, and everybody claimed that he cured them from ever getting HIV, even though it's simply not true.<p>Note that there are also drugs which disable CCR5, without gene modification (Selzentry).<p>[1] <a href="https://en.wikipedia.org/wiki/CCR5" rel="nofollow">https://en.wikipedia.org/wiki/CCR5</a>
[2] <a href="https://en.wikipedia.org/wiki/He_Jiankui_affair" rel="nofollow">https://en.wikipedia.org/wiki/He_Jiankui_affair</a>
> Only 1% of the total population carries this genetic mutation that makes them resistant to HIV.<p>Wow, I didn't even know that you can be immune to HIV. It's only a matter of time before we have technologies to change our genetic code or at least the genetic code of two cells before they form an embryo.
Recently there was a post on HN about some child whose genetic disease was cured by inserting DNA (can't remember the specifics). I wonder if something similar could be done with HIV. Obviously you'd have to insert a mutation for the CCR5 protein. Then the problem is you have all this bone marrow that's still producing white blood cells of the old type, so you'd need some way of killing off the old bone marrow cells without the right mutation and replacing them with the new ones.
Nice, but I wonder how long before it's going to be an option for all those who want it (even ignoring whether managing HIV may be better then curing it).<p>I'm still waiting for ocumetics bionic lenses to end glasses and contact lenses (ha ha ha, they're probably still collecting money from all the parties they should be destroying) and I lost hope we'll ever see RISUG, the male permanent but removable contraceptive without cancer-causing hormones.
Dup of the story I posted hour earlier from the source I believe better describe the whole situation:<p><a href="https://news.ycombinator.com/item?id=34871755" rel="nofollow">https://news.ycombinator.com/item?id=34871755</a>
Seems to me like every improvement in medical science will be accompanied by a corresponding decrease in individual responsibility. Just like hardware and software.<p>I've heard young people basically say 'HIV isn't a big deal nowadays so no need to worry'.