Thursday, February 12, 2009

Two bits of news in HIV today...


First of all, it looks like we have officially cured the first HIV+ positive patient of the disease. No, seriously, guys. Cured.
A 42-year-old HIV patient with leukemia appears to have no detectable HIV in his blood and no symptoms after a stem cell transplant from a donor carrying a gene mutation that confers natural resistance to the virus that causes AIDS, according to a report published Wednesday in the New England Journal of Medicine.

"The patient is fine," said Dr. Gero Hutter of Charite Universitatsmedizin Berlin in Germany. "Today, two years after his transplantation, he is still without any signs of HIV disease and without antiretroviral medication."
It breaks down like this: HIV requires a couple of things to attach to a cell in order to infect it. One of them is known as a CCR5 receptor. In some people (estimates are something like less than 1% of the population, and there may be some link to people whose ancestors survived the Black Plague), the CCR5 is mutated in a way that HIV cannot attach. This particular patient required a bone marrow transplant, and they chose a donor with the mutation. Since bone marrow=cell creation, the new cells produced also have this mutation. After two years, no sign of the disease.

This particular process, btw, is what is giving us hope (as mentioned before) for a much more broad based and possibly universal immunization and cure for HIV.

Since it's only been two years, we're still waiting to see if "cure" is still the right word.

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In prevention, we have the first of what seems like a microbicidal gel to show some hints at success:
The vaginal gel is produced by Indevus Pharmaceuticals in Lexington, Massachusetts and is based on a microbicide designed to kill the virus before it enters the body through the vagina or rectum. Microbicides are gels or creams for female use which can be applied vaginally or anally to prevent transmission of HIV.

“After working for over a decade in microbicide research, we are seeing a glimmer of hope of finding a safe and effective microbicide which could protect women and substantially reduce new HIV infections here in South Africa and globally,” Gita Ramjee, director of the HIV prevention research unit of the South African Medical Research Council was quoted as saying.

Microbicides, outside of a cure/immunization or pre/post exposure prophylaxis, are the great hope for the future of HIV prevention. Similar to spermicide, these would be substances inserted into the vagina (or anus) that would kill off the microbes causing STD's, like HIV. To date, the only one we've had -- nonoxynol-9 -- was a miserable failure because it actually leaded to irritation in the vaginal and rectal mucosae and an increase in HIV infection.

Oops.

This particular study shows great promise -- decreasing infection rates by 30% -- but the caveat, of course, is that it is only 30% and this number is not statistically significant, given the small size of the study. For it to be significant, they would have had to prove a decrease by 33%. That's very very close and close enough that they are going to widen the study and see if the data improves.

After all, out of 3000 participants in the study, only around 150 of them seroconverted at all. That's a very small number for research.

Oh, and New York City is getting smart, using social media to promote HIV and safer sex awareness... YEA! If any of you get on there and try it out, I want an e-condom, SO BADLY. :-)

1 comment:

Jere Keys said...

I can understand why people are hesitant to get overly excited about this just yet. That said, I hope it can at least generate some positive outlooks and inspire a new publicly-funded research (rather than putting all our eggs in the greedy pharmaceutical companies basket).