Showing posts with label Cure. Show all posts
Showing posts with label Cure. Show all posts

October 24, 2013

Baby Cured From HIV is For Real

cat

 A little girl who was treated for HIV shortly after birth still shows no sign of infection at age three, suggesting her apparent cure was not a fluke, US researchers said Wednesday.
The story of the first child known to have been cured of HIV through early treatment with powerful doses of antiretroviral drugs -- what researchers call "sustained remission" rather than a cure -- was initially announced in March when she was two and a half.
A handful of HIV-infected adults around the world have been described in medical literature as newly free of the disease, most famously Timothy Brown, also known as "the Berlin patient," who was given a bone marrow transplant for leukemia that wiped out his HIV as well.
But no easy method has emerged to eradicate the three-decade-old human immunodeficiency virus that infects 34 million people globally and is responsible for 1.8 million deaths each year.
The girl's updated case report in the New England Journal of Medicine also sought to answer questions raised by outside experts over whether she was ever really infected, by describing DNA and RNA tests that were positive for HIV just over a day after birth.
The child was given antiretroviral drugs until the age of age 18 months and, after a year and half without treatment, no sign of the disease has returned, the article said.
"Our findings suggest that this child's remission is not a mere fluke but the likely result of aggressive and very early therapy that may have prevented the virus from taking a hold in the child's immune cells," said lead author Deborah Persaud, a virologist and pediatric HIV expert at the Johns Hopkins Children's Center.
The child's mother gave birth to her prematurely, about a month early, and had not received any prenatal care. She was unaware that she was HIV positive until she was tested at the Mississippi hospital where she delivered.
The newborn also tested positive for HIV, and the high level found in her blood suggested that she had become infected with human immunodeficiency virus while in the womb, researchers said.
She also showed signs of HIV in blood tests at 19 days of age, data that "support the authors' perspective that the infant was truly infected," said an accompanying editorial by Scott Hammer, a leading HIV scientists at Columbia University Medical Center.
"The big question, of course, is, 'Is the child cured of HIV infection?' The best answer at this moment is a definitive 'maybe,'" he wrote.
A longer term follow up of the child is needed, he said, cautioning that her case may be "unique," even as it shows a proof of principle that may lead to more rigorous studies down the road.
The child was given antiretroviral drugs for the first 15-18 months of her life, when she was lost to follow up.
Her mother brought her back to doctors at 23 months of age, saying she had last given her anti-HIV medication at age 18 months.
"This happened almost by accident," said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.
"It wasn't that the doctor said 'let's stop the therapy.' This is not recommended for home use," he told AFP.
Tests at 23 months were negative for HIV, and by the time the child reached 30 months of age, tests still showed no sign of HIV or HIV antibodies, said the study.
"We're thrilled that the child remains off medication and has no detectable virus replicating," said pediatrician Hannah Gay of the University of Mississippi Medical Center.
"We've continued to follow the child, obviously, and she continues to do very well," said Gay, who first treated her.
"There is no sign of the return of HIV, and we will continue to follow her for the long term."
The girl's medical team believes the reason for her success was the early intervention, and they hope to investigate whether treating other infected infants within hours or days of birth could show similar outcomes.
A US-government funded study is set to begin in low and middle income countries in 2014 that would test the method in HIV-infected newborns on a wider scale, Fauci said.

July 4, 2013

Two HIV+ Patients After Bone Transplant for Cancer = No HIV Showing




HIV
  KUALA LUMPUR, Malaysia — Two HIV-positive patients in the United States who underwent bone marrow transplants for cancer have stopped anti-retroviral therapy and still show no detectable sign of the HIV virus, researchers said Wednesday.
The Harvard University researchers stressed it was too early to say the men have been cured, but said it was an encouraging sign that the virus hasn’t rebounded in their blood months after drug treatment ended. 
Two HIV-positive patients from Boston who underwent bone marrow transplants for cancer and stopped antiretroviral therapy, show no detectable sign of the HIV virus.
Timothy Henrich of the Harvard-affiliated Brigham and Women’s Hospital in Boston speaks at the International AIDS Society Conference 2013 in Kuala Lumpur, Malaysia, Wednesday, July 3, 2013.
The first person reported to be cured of HIV, American Timothy Ray Brown, underwent a stem cell transplant in 2007 to treat his leukemia. He was reported by his German doctors to have been cured of HIV two years later.
Brown’s doctors used a donor who had a rare genetic mutation that provides resistance against HIV. So far, no one has observed similar results using ordinary donor cells such as those given to the two patients by the Harvard University researchers.
The researchers, Timothy He nrich and Daniel Kuritzkes of the Harvard-affiliated Brigham and Women’s Hospital in Boston, announced last year that blood samples taken from the men – who both had blood cancers – showed no traces of the HIV virus eight months after they received bone marrow transplants to replace cancerous blood cells with healthy donor cells. The men were still on anti-HIV drugs at the time.
The men have both since stopped anti-retroviral therapy – one 15 weeks ago and the other seven weeks ago – and show no signs of the virus, Henrich told an international AIDS conference in Malaysia on Wednesday.
“They are doing very well,” Henrich said. “While these results are exciting, they do not yet indicate that the men have been cured. Only time will tell.”
The HIV virus may be hiding in other organs such as the liver, spleen or brain and could return months later, he warned.
Further testing of the men’s cells, plasma and tissue for at least a year will help give a cleare r picture on the full impact of the transplant on HIV persistence, he said.
Kuritzkes said the patients will be put back on the drugs if there is a viral rebound.
A rebound will show that other sites are important reservoirs of infectious virus and new approaches to measuring these reservoirs will be needed in developing a cure, Henrich said.
“These findings clearly provide important new information that might well alter the current thinking about HIV and gene therapy,” Kevin Robert Frost, chief executive of The Foundation of AIDS Research, said in a statement. “While stem cell transplantation is not a viable option for people with HIV on a broad scale because of its costs and complexity, these new cases could lead us to new approaches to treating, and ultimately even eradicating, HIV.”


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May 8, 2013

One More Nail in HIV’s Coffin } Drugs to go Directly to the Brain(Could Not Be Done Before)



 

Madhavan Nair (at right) and Sakhrat Khizroev, researchers from FIU's Herbert Wertheim College of Medicine developed a new technique that can deliver and fully release the anti-HIV drug AZTTP into the brain by using magneto-electric nanoparticles to cross the blood-brain barrier. Here the researchers give a demonstration of a magnet's pull on the nanoparticles.
Madhavan Nair (at right) and Sakhrat Khizroev, researchers from FIU's Herbert Wertheim College of Medicine developed a new technique that can deliver and fully release the anti-HIV drug AZTTP into the brain by using magneto-electric nanoparticles to cross the blood-brain barrier. Here the researchers give a demonstration of a magnet's pull on the nanoparticles.
PATRICK FARRELL / MIAMI HERALD

DCHANG@MIAMIHERALD.COM

Stumped for years by a natural filter in the body that allows few substances, including life-saving drugs, to enter the brain through the bloodstream, physicians who treat neurological diseases may soon have a new pathway to the organ via a technique developed by a physicist and an immunologist working together at Florida International University’s Herbert Wertheim College of Medicine.
The FIU researchers developed the technique to deliver and fully release the anti-HIV drug AZTTP into the brain, but their finding has the potential to also help patients who suffer from neurological diseases such as Alzheimer’s, Parkinson’s and epilepsy, as well as cancer.
“Anything where you have trouble getting drugs to the brain and releasing it, this opens so many opportunities,’’ said Madhavan Nair, an FIU professor and chair of the medical school’s immunology department.
In an in vitro laboratory test with HIV-infected cells, Nair and a colleague, Sakhrat Khizroev, a professor of immunology and electrical engineering, attached the antiretroviral drug AZTTP to tiny, magneto-electric nanoparticles. Then, using magnetic energy, they guided the drug across a cell membrane created in the lab to mimic the blood-brain barrier found in the human body.
Once the drug reached its target, researchers triggered its release from the nanoparticle by zapping it with a low-energy electrical current. The drug remained functional and structurally sound after the release, according to the experiment findings.
“We learned to control electrical forces in the brain using magnetics,’’ said Khizroev, who designed, oversaw and supervised the entire project. “We pretty much opened a pathway to the brain.’’
The test findings were published in April in the online peer-reviewed journal, Nature Communications. Researchers believe that using this method will allow physicians to send a higher level of AZTTP — up to 97 percent more — to HIV-infected cells in the brain.
Currently, more than 99 percent of the antiretroviral therapies used to treat HIV, such as AZTTP, are deposited in the liver, lungs and other organs before they reach the brain.
While anti-viral drugs have helped HIV patients live longer by reducing their viral loads, the drugs cannot pass the blood-brain barrier in significant amounts, which allows the virus to lurk unchecked in the brain and can lead to neurological damage, said Dr. Cheryl Holder, a practicing physician and FIU professor who specializes in treating patients with HIV.
“We know that even though the viral load is undetectable in the blood, we don’t know what’s going on in the brain fully,’’ Holder said.
HIV causes constant inflammation, she said, and the virus can pool in areas of the brain where medicine cannot reach, potentially causing damage.
“It’s important to get the drug to the brain,’’ she said, “to help prevent dementia in older patients, and inflammation.’’
But the ability to target drug delivery and release it on demand in the brain has been impossible without opening the skull, Nair and Khizroev said.
Nair, an immunologist who specializes in HIV research, and Khizroev, an electrical engineer and physicist, began collaborating on the project about 18 months ago after winning a National Institutes of Health grant to study the use of magnetic particles.
One of the keys to success was controlling the release of the drug without adversely affecting the brain.
The researchers found their solution in the magneto-electric nanoparticles, which are uniquely suited to deliver and release drugs in the brain, Khizroev said. These nanoparticles can convert magnetic energy into the electrical energy needed to release the drugs without creating heat, which could potentially harm the brain.
The development of a new, less invasive pathway to the brain would open the door to many new medical uses.
Khizroev said he recently returned from a trip to the University of Southern California, where he briefed physicians at the medical school on the technique and its potential for cancer treatment. And Nair said he received a letter recently on behalf of a 91-year-old man suffering from Parkinson’s, asking when the technique might become available for use in people.
That may take a while. With the first phase of testing successfully completed using in vitro experiments, the second will take place at Emory University in Georgia, where researchers will test the technique on monkeys infected with the HIV virus.
If researchers complete the second phase successfully, clinical trials on humans could follow, Nair said. Approval from the Food and Drug Administration would be required before the technique becomes commercially available, he said.
FIU researchers have applied for a patent and would receive royalties, they said, though the university would benefit the most, in part because a successful research project could open opportunities for more grant funding on other topics.
For Khizroev, who had previously done research on quantum computing and information processing, the project has offered a way to put his scientific knowledge to use in a way that could have a direct affect on people’s health.
“I wanted to apply my knowledge of nanoparticles to something important,’’ he said.

Read more here: http://www.miamiherald.com/2013/05/06/v-fullstory/3383267/fiu-researchers-develop-new-pathway.html#storylink=cpy

April 27, 2013

Umbilical Cord Blood (Not Readily Available Thanks to Last Pres.)= HIV Cured?


Timothy Ray Brown the Berlin Patient, HIV, AIDS, Washington Blade photo by Michael Key

                                       Timothy Ray Brown, the first person ever cured of HIV, is working with
                                                  other patients seeking a cure. (Blade photo by Michael Key)

Doctors in Minnesota performed a first-ever procedure on a young boy that could lead to finding a cure for both HIV and leukemia. This case is similar to that of Timothy Ray Brown (also known as “the Berlin Patient”), a founder of our organizations, the Timothy Ray Brown Foundation and the World AIDS Institute. If successful, it will be the first time a person has been cured of HIV as a direct result of an umbilical cord blood transplant. 
The use of umbilical cord blood is still controversial in this country, with most of the opposition fueled by politics and religion. Today, Dr. Wagner told us, there is a very small amount of umbilical cord blood being released or available for medical procedures such as the one performed last week.  His team was permitted access to only a small fraction of cord blood.

What if cord blood were more readily available?  Consider the immediate and long-term impact on all sorts of diseases, beyond leukemia and HIV.

An hour after the procedure was completed, Timothy called the young boy to wish him all the success in the world for a good and speedy recovery. “When I had my procedure done, I got caught up in the trap of lying around in my bed in the hospital watching television and not exercising,” Timothy told the boy. “Make sure as soon as you are able, get out of bed and do some exercise, go do what you love, go play some basketball.” Timothy said he could hear the boy’s mother and team of doctors laughing, as they seconded the sound strategy.
Timothy’s procedure has been performed on others in Germany, but none has survived.  “It became almost too much,” Timothy said. “I would receive one phone call after another letting me know another patient who received the same procedure I did had passed away.” In many cases, the leukemia and HIV was just too much for their frail bodies. In all cases, there were multiple stem cell donors available for each patient. But that was in Germany, not here.”
It is unfortunate the United States puts political and religious beliefs over potential life-saving scientific and medical discoveries. We have so much to be proud of in our country as it relates to science and medicine and also much cause for shame. In the case of the boy in Minnesota and Timothy Ray Brown, both could have said no to the groundbreaking procedures.  Instead, they said yes, giving a major push to finding a cure for HIV for everyone.
What is really quite beautiful is the impact of physical hardship on the human spirit — a man and a boy now share virtually the same experience medically, yet it’s also different. One received stem cells from an adult, the other umbilical cord blood from a baby. However in the end, it very well may be that Timothy Ray Brown, the first person ever cured of HIV, now will have more company. More importantly, he has a new friend and a potential new leader who might understand what it’s like to be cured of AIDS.
Dave Purdy is founder and CEO of the World AIDS Institute (worldaidsinstitute.org). Reach him at dpurdy@worldaidsinstitute.org.

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