Bone marrow transplant provides possible AIDS cure

German hematologists Eckhard Thiel, left, and Gero Huetter of Berlin’s Charite Medical University attend a news conference about the successful treatment of an HIV-infected patient in Berlin

An American man who suffered from both AIDS and leukemia appears to be free of HIV after a bone marrow transplant performed in Germany several months ago.

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.

In what can practically be called an experiment the patient underwent powerful chemotherapy and radiation to kill off his infected bone marrow and then received not only healthy marrow but marrow containing CCR5, which may provide natural resistance to the AIDS virus.

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.

This treatment is not without great risk, as 20 to 30 percent of leukemia patients die in this process. But this unique situation, where the risk was worth taking, may provide an important starting point for finding out if similar techniques can cure HIV in patients who do not have leukemia and would not otherwise receive bone marrow transplants.

Doctors urge caution. Just because the patient has been HIV-free for 20 months does not mean that the virus will never resurface. And because this specific case was something of a fluke, further experimentation will surely have to start well behind human clinical trials. But it does provide hope that we are striding down the right path towards a cure.

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