Bone Marrow Transplants for HIV
The two men developed Hodgkin’s lymphoma, a cancer of the blood, and both went through chemotherapy which failed. At this point, doctors decided to use a bone marrow transplant to replace the patient’s cancerous blood cells with healthy, donor cells.
The doctors deliver healthy, donor stem cells via a tube called a central venous catheter – the cells travel through the patient’s blood and to the bone marrow. The new healthy cells then begin to replicate and take over. However, these stem cells don’t always ‘take’, – this means that the body may reject the cells.
Other complications such as infections can be very serious in patients who have had a bone marrow transplant. Damage to the kidneys, liver, and heart can also occur.
Decoded Science had the opportunity to interview Dr. Henrich, co-presenter of this research, and asked whether a bone marrow transplant is a good option for all HIV patients. Dr. Henrich explains,
“Allogeneic hematopoietic stem cell transplantation is associated with a 15-20% mortality within the first few years. The procedure is also very expensive, and patients may need long-term immunosuppressive medications to minimize donor cells from attacking the patient’s own tissues. It is also unknown if allogeneic hematopoietic stem cell transplantation can eliminate the HIV reservoir in all infected patients or if it will work in only a few select individuals.”
The Berlin Patient
There has been only one person that has been cured of HIV – American Timothy Ray Brown.
Brown, also known as the ‘Berlin patient’, also had a bone marrow transplant in 2009 for leukemia and German doctors declared him as cured of HIV. The difference between Brown and the two Boston patients is that Brown received stem cells from a donor that had a rare gene mutation called CCR5-delta32, which is though to be resistant to HIV, whereas the Boston patients received ordinary donor cells. The other key difference is that Brown stopped all ART medications immediately after his transplant, whereas the Boston patients remained on their ART medications until just recently.
New HIV Treatment: Bone Marrow Transplant
Bone marrow transplants come with risky complications and may not be for everyone with HIV. However, there are new advances that are continuing to provide better treatment to HIV/AIDS patients, like starting ART medications sooner. As for when this could be called a cure, Dr. Henrich says, “It is possible that virus could return off therapy in both of our patients in the coming days, weeks or months. It is also possible that virus could return up to 2 years after interrupting therapy. Long term follow-up will be required to fully understand the impact of stem cell transplantation with susceptible cells on HIV-1 persistence.”
BBC News. Bone Marrow ‘frees men of HIV drugs.’ July 3, 2013. Accessed July 3, 2013.
Boston. Boston Researchers report encouraging HIV findings. July 3, 2013. Accessed July 3, 2013.
EurkAlert. Bone Marrow Transplant Eliminates Signs of HIV. July 26, 2012. Accessed July 3, 2013.
Medline Plus. Bone Marrow Transplant. Updated February 7, 2012. Accessed July 3, 2013.