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David Mittleman
David Mittleman
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A Possible Breakthrough for the Treatment of AIDS

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It has been over 27 years since the acquired immunodeficiency syndrome, or AIDS, was first reported in the United States in the early 1980’s. The syndrome is a set of infections and symptoms that grow out of the human immunodeficiency virus or HIV. HIV is transmitted through direct contact with mucous membrane or the bloodstream with a bodily fluid that is infected with HIV. Transmission of HIV can involve any form of sexual intercourse, blood transfusions, sharing contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, or breast feeding.

AIDS in a world-wide pandemic, with an estimated 33.2 million people having lived with the disease, and kills an estimated 2 million people from all social and economic groups each year. HIV and AIDS have been treated with the use of antiretroviral medication, which reduces the mortality and morbidity of the HIV infection. However, this treatment is expensive and not available in many countries.

An American man living in Berlin, who had been infected with the AIDS virus for more than 10 years, underwent a genetically selected bone marrow transplant. The result appears to be nothing short of a medical miracle. Twenty months after undergoing the procedure, he no longer tests positive for AIDS. Doctors at Charite Hospital and Medical School in Berlin say that tests on his bone marrow, blood and tissues have all been clean.

The patient’s doctors caution that this may be just a fluke. There is no doubt that this case is the brightest hope that we have seen in the history of this worldwide plague. This is not the first time that bone marrow transplants have been used in an attempt to treat HIV/AIDS. There had been 32 previous attempts between 1982 and 1996, of which two cases showed an eradication of HIV.

The procedure was developed by Dr. Gero Huetter, who is a hematologist. He set out to treat the patient’s leukemia with a bone marrow transplant, and remembered that he had read an article that discussed a genetic mutation in some people that seemed to make them resistant to HIV infection. The mutation, called Delta 32, prevents HIV from attaching itself to cells by blocking a gateway receptor called CCR5. The mutation must be inherited from both parents, with only one out of every thousand Europeans and Americans. Dr. Huetter was able to find a donor that matched the patients bone marrow type from a pool of 80 suitable donors.

The patient had to endure powerful radiation and drug therapy to kill the infected bone marrow cells and disable his immune system. This treatment is fatal to recipients 20-30% of the time. Due to the risks and expense of the treatment, it is not ready to be an initial treatment method. But this could be the first step in leading to the development of gene therapy through stem-cell research, which is necessary to block the expression of CCR5, therefore inhibiting the ability of HIV from replicating. Some day this treatment could be the new standard of care for AIDS treatment, and failure to offer this course of therapy could subject doctors to liability for medical malpractice.

Although this new development gives reason for optimism, prevention is still the first line of defense against HIV. It is important to practice safe sex or abstinence, use sterilized hypodermic needles, and get tested for HIV/AIDS.