Effectiveness of Bone Marrow Transplant in Suppressing HIV Creates Hope for Gene-Therapy Strategies in Treating Virus, Wall Street Journal Reports
November 7, 2008
The Wall Street Journal on Friday examined the case of an HIV-positive person who underwent a bone marrow transplant to treat leukemia and who has had undetectable HIV viral loads for almost two years. The procedure -- performed by German hematologist Gero Hutter of Berlin's Charite Medical University on a 42-year-old American living in the city -- "is stirring new hope that gene-therapy strategies on the far edges of AIDS research might someday cure the disease," the Journal reports.
David Baltimore, who won a Nobel prize for his research on tumor viruses, said the case is "a very good sign" and a virtual "proof of principle" for gene-therapy approaches, but he cautioned that it could be a fluke. However, researchers who recently have reviewed the case believe that although it is likely that some HIV remains in the patient, it cannot "ignite a raging infection, most likely because its target cells are invulnerable mutants." According to the Journal, the researchers agreed that the patient is "functionally cured." Nevertheless, research has shown that blocking CCR5 can have fatal consequences, and bone-marrow transplants, which are given only to later-stage cancer patients, can result in death among 30% of patients. The Journal reports that although "scientists are drawing up research protocols to try this approach on other leukemia and lymphoma patients, they know it will never be widely used to treat AIDS because of the mortality risk."
Although re-engineering a patient's own cells through gene therapy could be a safer alternative, such strategies face "daunting technical challenges," the Journal reports. However, several research groups are testing different approach to treating HIV/AIDS, "[e]xpecting that gene therapy will eventually play a major role in medicine" (Schoofs, Wall Street Journal, 11/7).
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