Posts Tagged ‘hiv/aids’
[LINK] “US doctors cure child born with HIV”
This article by Guardian science correspondent Ian Sample made the rounds of Facebook as amazing, but in the light of day looks less like a miracle and more a reasonable extension upon the proven successes of post-exposure prophylaxis drug treatments in preventing HIV infection in people exposed to the virus. As the author points out, this treatment is likely to be most useful for children born to HIV-infected mothers who haven’t already received treatment.
Doctors did not release the name or sex of the child to protect the patient’s identity, but said the infant was born, and lived, in Mississippi state. Details of the case were unveiled on Sunday at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
Dr Hannah Gay, who cared for the child at the University of Mississippi medical centre, told the Guardian the case amounted to the first “functional cure” of an HIV-infected child. A patient is functionally cured of HIV when standard tests are negative for the virus, but it is likely that a tiny amount remains in their body.
[. . .]
The number of babies born with HIV in developed countries has fallen dramatically with the advent of better drugs and prevention strategies. Typically, women with HIV are given antiretroviral drugs during pregnancy to minimise the amount of virus in their blood. Their newborns go on courses of drugs too, to reduce their risk of infection further. The strategy can stop around 98% of HIV transmission from mother to child.
[. . .]
The problem is far more serious in developing countries. In sub-Saharan Africa, around 387,500 children aged 14 and under were receiving antiretroviral therapy in 2010. Many were born with the infection. Nearly 2 million more children of the same age in the region are in need of the drugs.
In the latest case, the mother was unaware she had HIV until after a standard test came back positive while she was in labour. “She was too near delivery to give even the dose of medicine that we routinely use in labour. So the baby’s risk of infection was significantly higher than we usually see,” said Gay.
Doctors began treating the baby 30 hours after birth. Unusually, they put the child on a course of three antiretroviral drugs, given as liquids through a syringe. The traditional treatment to try to prevent transmission after birth is a course of a single antiretroviral drug. The doctor opted for the more aggressive treatment because the mother had not received any during her pregnancy.
Several days later, blood drawn from the baby before treatment started showed the child was infected, probably shortly before birth. The doctors continued with the drugs and expected the child to take them for life.
However, within a month of starting therapy, the level of HIV in the baby’s blood had fallen so low that routine lab tests failed to detect it.
[. . .]
When the mother and child arrived back at the clinic [two years later], Gay ordered several HIV tests, and expected the virus to have returned to high levels. But she was stunned by the results. “All of the tests came back negative, very much to my surprise,” she said.
[LINK] “In Girl’s Last Hope, Altered Immune Cells Beat Leukemia”
We know we live in a science-fiction present by the fact that–as reported by the New York Times‘s Denise Grady–the latest hot cure for cancer involves the use of a tailored version of HIV. 30 years ago, HIV hadn’t been isolated in the laboratory, but now …
It is hard to believe, but last spring Emma [Whiteside], then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.
Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the virus that causes AIDS to reprogram Emma’s immune system genetically to kill cancer cells.
The treatment very nearly killed her. But she emerged from it cancer-free, and about seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.
[. . .]
“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.
Three adults with chronic leukemia treated at the University of Pennsylvania have also had complete remissions, with no signs of disease; two of them have been well for more than two years, said Dr. David Porter. Four adults improved but did not have full remissions, and one was treated too recently to evaluate. A child improved and then relapsed. In two adults, the treatment did not work at all. The Pennsylvania researchers were presenting their results on Sunday and Monday in Atlanta at a meeting of the American Society of Hematology.
Despite the mixed results, cancer experts not involved with the research say it has tremendous promise, because even in this early phase of testing it has worked in seemingly hopeless cases. “I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.
[. . .]
To perform the treatment, doctors remove millions of the patient’s T-cells — a type of white blood cell — and insert new genes that enable the T-cells to kill cancer cells. The technique employs a disabled form of H.I.V. because it is very good at carrying genetic material into T-cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turn malignant in leukemia.
The altered T-cells — called chimeric antigen receptor cells — are then dripped back into the patient’s veins, and if all goes well they multiply and start destroying the cancer.
The T-cells home in on a protein called CD-19 that is found on the surface of most B-cells, whether they are healthy or malignant.
[BLOG] Some Wednesday links
- The Burgh Diaspora’s Jim Russell notes how Brazil is using the Afro-Brazilian majority legacy of the transatlantic slave trade to justify the construction of new transatlantic links with Africa.
- Crooked Timber comments upon the Irish anti-abortion laws that just cost a woman her life and the homophobia of the Reagan administration that made HIV/AIDS a laughing matter.
- Daniel Drezner wonders if the ongoing expanding Petraeus scandal will end up diminishing the American public’s regard for the military.
- Eastern Approaches notes that no one in the Balkans seems to be commemorating the one hundredth anniversary of the First Balkan War.
- Far Outlier’s Joel quotes from Matthew Restall’s Seven Myths of the Spanish Conquest to describe how Christopher Columbus was really riding on the coat-tails of Portugal’s successful long-range maritime exploration.
- Geocurrents observes efforts by some Arab Christians in the Levant to revive Aramaic.
- The Global Sociology Blog reviews Laurent Dubois’ Haiti: The Aftershocks of History, highlighting the extent to which Haiti’s catastrophes are the products of foreign meddling.
- At Lawyers, Guns and Money, Erik Loomis maps Detroit. The extent to which the borders of the City of Detroit overlap with African-American majority populations, and to which the sprawl of Metro Detroit is constructed so as to detach the suburbs from any responsibility for the city at their region’s center, is noteworthy.
- The Planetary Science Blog’s Emily Lakdawalla reports on Carl Sagan’s feminism.
- The Power and the Money’s Noel Maurer summarizes what’s going on with Uruguay’s decriminalization of marijuana for personal use.
[BRIEF NOTE] On the recent Supreme Court of Canada ruling on criminal transmission of HIV
Last week’s ruling by the Supreme Court of Canada–reported by the CBC, among others–establishing the terms on which people infected with HIV could have sex with uninfected people got international coverage. (See Joe. My. God. and Towleroad, for instance.)
Briefly, the Supreme Court revisited the 1998 case of R. v. Cuerrier, where it was ruled that knowingly exposing a sexual partner to HIV at all would constitute sexual assault. In the era of HAART and other medical therapies which can sharply limit the presence of the HIV virus in bodily fluids, thus sharply reducing potential infectiousness, the court ruled unanimously–9-0–that so long as someone infected with HIV had a low viral load and wore a condom, disclosure was not necessary.
I’m not entirely sure what I feel about this. I don’t quite buy the sentiment, expressed in Xtra! as well as by some of the CBC’s interviewees, that this represents an intrusion on civil liberties. I know that there are people who are willing to expose their sexual partners to HIV without bothering to ask their consent, I think the criminal transmission of HIV should remain a criminal act in Canada as a form of assault, and I suspect that this ruling, taking into account the latest findings of medical research as it does, is about as finely-tuned as one can reasonably expect. Is it, though?
A lawyer for the B.C. Civil Liberties Association, which was an intervener in the case, was disappointed that the Supreme Court decision did not go further.
“My client’s position is that the criminal law is a harsh tool that should be reserved for the most morally blame-worthy cases,” said Michael Feder.
“What you’re talking about here is a vulnerable, marginalized group of people who are going to be forced to go around volunteering to anyone with whom they’re going to have sexual contact, that they belong to that vulnerable, marginalized group,” he said.
Richard Elliott, the executive director of the Canadian HIV/AIDS Legal Network, which also intervened in the case, said the decision was not a good one for people living with HIV.
His group’s position is that either a low viral load or the use of a condom should be the required test to avoid being prosecuted, but not both, as the top court said in Friday’s ruling.
“We know from the science now that if either you use a condom or you have a low viral load, the risk of transmission is extraordinarily small,” he said.
Jessica Whitbread, who contracted HIV from a former boyfriend more than a decade ago, said she thought Friday’s ruling was a step forward — at first. But upon closer examination, she said this ruling could make her the criminal.
“I can still have a vindictive lover say that I did or didn’t use a condom,” she told CBC News. “It still becomes ‘he said, she said. he said, he said.’ …That can still play a very important role in the courts.”
[BRIEF NOTE] On the recent Supreme Court of Canada ruling on criminal transmission of HIV
Last week’s ruling by the Supreme Court of Canada–reported by the CBC, among others–establishing the terms on which people infected with HIV could have sex with uninfected people got international coverage. (See Joe. My. God. and Towleroad, for instance.)
Briefly, the Supreme Court revisited the 1998 case of R. v. Cuerrier, where it was ruled that knowingly exposing a sexual partner to HIV at all would constitute sexual assault. In the era of HAART and other medical therapies which can sharply limit the presence of the HIV virus in bodily fluids, thus sharply reducing potential infectiousness, the court ruled unanimously–9-0–that so long as someone infected with HIV had a low viral load and wore a condom, disclosure was not necessary.
I’m not entirely sure what I feel about this. I don’t quite buy the sentiment, expressed in Xtra! as well as by some of the CBC’s interviewees, that this represents an intrusion on civil liberties. I know that there are people who are willing to expose their sexual partners to HIV without bothering to ask their consent, I think the criminal transmission of HIV should remain a criminal act in Canada as a form of assault, and I suspect that this ruling, taking into account the latest findings of medical research as it does, is about as finely-tuned as one can reasonably expect. Is it, though?
A lawyer for the B.C. Civil Liberties Association, which was an intervener in the case, was disappointed that the Supreme Court decision did not go further.
“My client’s position is that the criminal law is a harsh tool that should be reserved for the most morally blame-worthy cases,” said Michael Feder.
“What you’re talking about here is a vulnerable, marginalized group of people who are going to be forced to go around volunteering to anyone with whom they’re going to have sexual contact, that they belong to that vulnerable, marginalized group,” he said.
Richard Elliott, the executive director of the Canadian HIV/AIDS Legal Network, which also intervened in the case, said the decision was not a good one for people living with HIV.
His group’s position is that either a low viral load or the use of a condom should be the required test to avoid being prosecuted, but not both, as the top court said in Friday’s ruling.
“We know from the science now that if either you use a condom or you have a low viral load, the risk of transmission is extraordinarily small,” he said.
Jessica Whitbread, who contracted HIV from a former boyfriend more than a decade ago, said she thought Friday’s ruling was a step forward — at first. But upon closer examination, she said this ruling could make her the criminal.
“I can still have a vindictive lover say that I did or didn’t use a condom,” she told CBC News. “It still becomes ‘he said, she said. he said, he said.’ …That can still play a very important role in the courts.”
[BLOG] Some Tuesday links
- Bag News Notes discusses the famous Times Square kiss photo, placing it in the context of the general invisibility of sexual assault.
- Centauri Dreams discusses two proposed probes for Saturn’s moon Titan, one a flier that takes advantage of the world’s dense atmosphere the other a boat that would float on one of that world’s hydrocarbon seas.
- Daniel Drezner is conflicted about Last Resort, a new NBC TV series featuring a nuclear submarine crew gone rogue that doesn’t adequately consider the effect of nuclear weapons use.
- Far Outliers introduces readers to the Cossack pirates of the Black Sea.
- Joe. My. God shares the argument of writer and humourist Fran Lebowitz that gay marriage would have been unthinkable without the onslaught of HIV/AIDS.
- Language Hat shares the argument of one scholar who argues that the shift in the Russian name for the Russian language from Rossiiskii to Russkii in the early 19th century was a consequence of Russian imperialism in Poland.
- Supernova Condensate alerted me to the news that Voyager 1 may finally have left the Solar System.
- Without David Plummer’s Torontoist post examining the subject, I would never have known that Fritz Lerner’s musical Camelot–starring Richard Burton and Julie Andrews, no less!–had a remarkably fraught first staging in Toronto.
- Understanding Society takes a look at the economic histories of early modern India and China and finds that they seem not to have been substantially different from that of contemporary Europe.
- The Volokh Conspiracy’s Stewart Baker highlights a report from the American Congress critical of Huawei (and ZTT) for sloppy security and intellectual-property practices.
[LINK] “Bone marrow transplant eliminates HIV traces from two patients’ DNA: Call it a cure?”
Via Towleroad, I found this CBS article by Ryan Jaslow reporting on a noteworthy step in the development of a cure for HIV.
Two men who’ve had HIV for years may now be free of the disease following bone marrow transplants, researchers at Brigham and Women’s Hospital in Boston announced Thursday.
[. . .]
Both patients were being treated for cases of cancer. One of the patients underwent a bone marrow transplant two years ago at the Dana-Farber/Brigham and Women’s Cancer Center in Boston, the other had the procedure done four years ago at the same hospital. NBCNews.com reports that one of the patients is in his 50s and has been infected since the early 1980s towards the beginning of the AIDS epidemic and the other man, in his 20s, was infected at birth.
Both stayed on their antiretroviral medication regimens, the standard treatment of HIV, following the transplants.
The researchers discovered that overtime as the patients’ cells were replaced by cells from the donor, evidence of HIV in the patients’ blood tests disappeared. The researchers also said both patients have no signs of HIV in their DNA or RNA and levels of their disease-fighting antibodies have also decreased. The researchers think the medications helped allow these cells to be replaced.
“This gives us some important information,” one of the researchers Dr. Daniel Kuritzkes, an infectious disease specialist at the hospital and Harvard Medical school said in a press release. “It suggests that under the cover of antiretroviral therapy, the cells that repopulated the patient’s immune system appear to be protected from becoming re-infected with HIV.”
[. . .]
The researchers’ announcement comes days after Timothy Ray Brown, the man known as the “Berlin Patient,” held a press conference in Washington, D.C., to say he’s still cured of AIDS five years after undergoing a bone marrow blood transplant.
However, the researchers noted differences in their two patients’ treatment compared to that of Brown.
In Brown’s case, his donor was specifically chosen because he possessed a genetic mutation that’s found in one person of Caucasian people that makes them resistant to developing HIV. But the donors for the two Boston patient were selected at random. Additionally, Brown had stopped taking his antiretroviral medications following his transplant, while the Boston patients have stayed on the drugs.
[LINK] “Bone marrow transplant eliminates HIV traces from two patients’ DNA: Call it a cure?”
Via Towleroad, I found this CBS article by Ryan Jaslow reporting on a noteworthy step in the development of a cure for HIV.
Two men who’ve had HIV for years may now be free of the disease following bone marrow transplants, researchers at Brigham and Women’s Hospital in Boston announced Thursday.
[. . .]
Both patients were being treated for cases of cancer. One of the patients underwent a bone marrow transplant two years ago at the Dana-Farber/Brigham and Women’s Cancer Center in Boston, the other had the procedure done four years ago at the same hospital. NBCNews.com reports that one of the patients is in his 50s and has been infected since the early 1980s towards the beginning of the AIDS epidemic and the other man, in his 20s, was infected at birth.
Both stayed on their antiretroviral medication regimens, the standard treatment of HIV, following the transplants.
The researchers discovered that overtime as the patients’ cells were replaced by cells from the donor, evidence of HIV in the patients’ blood tests disappeared. The researchers also said both patients have no signs of HIV in their DNA or RNA and levels of their disease-fighting antibodies have also decreased. The researchers think the medications helped allow these cells to be replaced.
“This gives us some important information,” one of the researchers Dr. Daniel Kuritzkes, an infectious disease specialist at the hospital and Harvard Medical school said in a press release. “It suggests that under the cover of antiretroviral therapy, the cells that repopulated the patient’s immune system appear to be protected from becoming re-infected with HIV.”
[. . .]
The researchers’ announcement comes days after Timothy Ray Brown, the man known as the “Berlin Patient,” held a press conference in Washington, D.C., to say he’s still cured of AIDS five years after undergoing a bone marrow blood transplant.
However, the researchers noted differences in their two patients’ treatment compared to that of Brown.
In Brown’s case, his donor was specifically chosen because he possessed a genetic mutation that’s found in one person of Caucasian people that makes them resistant to developing HIV. But the donors for the two Boston patient were selected at random. Additionally, Brown had stopped taking his antiretroviral medications following his transplant, while the Boston patients have stayed on the drugs.
