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admin 10.11.2014

German scientists have managed to remove HIV from cells while leaving those cells alive - opening the door to potential cures for the disease. True, the news hit hard last month that the so-called "Boston patients" - two men who received bone marrow transplants that appeared to rid them completely of the AIDS-causing virus - had relapsed and gone back onto antiretroviral treatment. But experts say the disappointment could lay the basis for important leaps forward in the search for a cure.
He and other experts say the primary practical message is that current tests designed to detect even very low levels of HIV present in the body are simply not sensitive enough.
As well as having the human immunodeficiency virus (HIV), the Boston patients both also had a type of blood cancer called lymphoma, for which they were treated using bone marrow transplants - one man in 2008 and the other in 2010.
They continued taking the antiretroviral AIDS drugs, but eight months after each patient's transplant, doctors found they could not detect any sign of HIV in their blood. In the early part of 2013, both patients decided to stop taking their AIDS drugs and both appeared to remain HIV-free - prompting their doctors, Timothy Henrich and Daniel Kuritzkes from Boston's Brigham and Women's Hospital, to announce at a conference in July that they may have been cured.
Yet in December came news that one of the men had begun to show signs of an HIV rebound by August, while the second patient had a relapse in November. Henrich said the virus' comeback underlined how ingenious HIV can be in finding hiding places in the body to evade attack efforts by the immune system and by drug treatment.


INSPIRATION Barely a decade ago, few HIV scientists would have dared put the words HIV and cure in the same sentence. Yet some intriguing and inspiring cases in recent years mean many now believe it is just a question of time before a cure is found. First was the now famous case of Timothy Ray Brown, the so-called "Berlin patient," whose HIV was eradicated by a complex treatment for leukemia in 2007 involving the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection. Seven different teams demonstrated solutions, but in the end, none thought automation could realistically handle the task in the near future. Such an elaborate, expensive and life-threatening procedure could never be used as a broad-spectrum approach for the world's 34 million HIV patients. But the results in Brown focused scientific attention on a genetic mutation known as 'CCR5 delta 32' as a target for possible gene therapy treatment.
The only real exception is for video which is part of an open case currently under investigation. Then last March, French scientists who followed 14 HIV-positive people known as the "Visconti patients", who were treated very swiftly with HIV drugs but then stopped treatment, said that even after seven years off therapy, they were still showing no signs of the virus rebounding.
That announcement came only weeks after news of the "functional cure" of an HIV-positive baby in Mississippi who received antiretroviral treatment for 18 months from the day she was born.


A "functional cure" is when HIV is reduced to such low levels that it is kept at bay even without treatment, though the virus can still be detected in the body. Sharon Lewin, an HIV expert at Monash University in Australia, said all these developments, as well as the setback suffered by the Boston patients, inspired scientists to investigate many different approaches in the search for a cure.
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