Washington Blade - November 21, 2008

The virus has infected 33 million people worldwide. 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.

"We waited every day for a bad reading," Huetter said. It has not come. Researchers at Berlin's Charite hospital and medical school say tests on his bone marrow, blood and other organ tissues have all been clean. However, Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., said those tests have probably not been extensive enough. "A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Badley said.

This isn't the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported. Huetter's patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV. As Huetter - who is a hematologist, not an HIV specialist - prepared to treat the patient's leukemia with a bone marrow transplant, he recalled that some people carry a genetic mutation that seems to make them resistant to HIV infection.

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.

"I read it in 1996, coincidentally," Huetter told reporters at the medical school. "I remembered it and thought it might work." Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient's marrow type. Out of a pool of 80 suitable donors, the 61st person tested carried the proper mutation. Before the transplant, the patient endured powerful drugs and radiation to kill off his own infected bone marrow cells and disable his immune system - a treatment fatal to between 20 and 30 percent of recipients.

He also was taken off the potent drugs used to treat his AIDS. Huetter's team feared that the drugs might interfere with the new marrow cells' survival. They risked lowering his defenses in the hopes that the new, mutated cells would reject the virus on their own. Anthony Fauci, director of the National Institute of Allergy & Infectious Diseases in the U.S., said the procedure was too costly and too dangerous to employ as a firstline cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV.

More countries make spreading HIV a crime

LONDON (AP) - An increasing number of countries worldwide are making spreading HIV a crime, according to a new report from the International Planned Parenthood Federation. The report says 58 countries worldwide have laws that criminalize HIV or use existing laws to prosecute people for transmitting the virus. Another 33 countries are considering similar legislation. "If the law is applied badly, this could set us back and do incredible damage," said Paul de Lay, an AIDS expert at UNAIDS, who was not involved in the report. De Lay said the laws could result in forced testing and drive the epidemic underground.

Dutch court sentences 2 in HIV injection case

AMSTERDAM, Netherlands (AP) - A Dutch court convicted two men Nov. 12 for attempting to infect 14 victims with HIV in a bizarre sex case. The Groningen District Court found the two guilty of severe assault for injecting semiconscious men with HIV-infected blood at sex parties between January 2006 and May 2007. Peter M., 49, who was also convicted of rape, was sentenced to nine years in prison and Hans J., 39, received a five-year sentence. Under Dutch privacy laws, the surnames of convicted criminals are not released.

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