Hope of a cure for the Human Immunodeficiency Virus (HIV) came about two weeks ago when Nature reported that a man may have been cured of both HIV and leukaemia after receiving a stem-cell transplant from a donor who is genetically resistant to the virus.
For the over 33 million people currently living with the virus across the globe, there could not have been better news now.
The breakthrough was reported two years after the two German physicians performed the stem cell transplant on the patient at a Berlin hospital.A most interesting aspect of the report is that there is still no sign of the virus, even though the patient no longer takes antiretroviral drugs.This feat may have brightened the hope for science as it has, in recent time, recorded series of failures in the quest to invent technologies for preventing the virus from spreading.
Less than one year ago, some African scientists working in the field of HIV said science may have temporarily lost direction on what the next line of action should be in the search for a vaccine against the Human Immunodeficiency Virus (HIV) and its attendant condition, Acquired Immune Deficiency Syndrome (AIDS).
The scientists, who attended a workshop by the African AIDS Vaccine programme (AAVP) in Entebbe, Uganda, were saddened by the series of failures trailing various attempts to develop better HIV prevention technologies.
First to voice out then, was Chairperson of the African AIDS Vaccine Programme (AAVP)’s steering committee, Dr.Pontiano Kaleebu.He has been involved in the search for an HIV vaccine, ever since scientists began working on the vaccine in the 1980s.
Prominent among the string of failures recorded so far in attempts to develop veritable tools for the prevention of HIV infections include the cellulose sulphate microbicide failure, failures recorded in the use of female diaphragm (condom) and the suspension of Adeno five vaccine trial by Merck, all in 2007.These failures also extended into year 2008, which recorded failures in Acyclovir drugs for Herpes Simplex Virus (HSV) in high-risk negative people as well as the inability of science to devise ways of preventing infection among circumcised but HIV positive men and negative women, just as the Carraguard microbicide and Pro2000 microbicide could not scale the hurdle as well.
Of particular worry to the scientists is the apparent lack of idea among them on what went wrong or right in all of the failed attempts.
"It is no longer certain to the scientists working in the field of AIDS vaccine what they may have done wrong or if they are on the right path," Kaleebu said.
This trend has become worrisome to the scientific world as records from the UNAIDS show that HIV continues to spread globally with 15,000 new infections being recorded every day, five million per year.95 percent of these are recorded in developing countries as a result of inadequate access to preventive and therapeutic interventions in developing countries.
It is in view of this that the feat by the German physicians makes a lot of scientific sense.They announced their finding in November 2008.Since then, the results have been peer reviewed and are now published in the New England Journal of Medicine.
In carrying out this procedure, the physicians searched donor registries for bone-marrow donors, who were a match for their patient, and prepared to perform a transplant.
But haematologist, Gero Htter, of the Charite University tsmedizin in Berlin, took the search for a donor one step further.Nature reports states that Hžtter does not specialise in HIV cases but remembered a paper he had read more than a decade earlier about HIV resistance in people who carry a specific genetic mutation when he realised that his patient would need a transplant.
The patient had 80 matches in the bone-marrow registries of the German Bone Marrow Donor Center, and Hžtter reasoned that one of those matches might also carry CCR5 mutations.Donor number 61 turned out to be the one, and in February 2007, the transplant was performed.
In a reaction to this feat, Chemical Pathologists and Dean, Faculty of Clinical Medicine at Delta State University, Abraka, Professor Fred Jarikre, told Daily Independent that the feat is a possibility that could be replicated, even in Nigeria, given the political will.
"Stem Cell researches and procedures are very intensive and expensive to run, a reason one would say it will take time for countries like Nigeria to tap into the advanced stage benefit.But with good political will on the part of the government, it is possible," Jarkikre said.
Meanwhile, he said for the achievement to be published and peer reviewed by credible journals like Nature and the New England Journal of Medicine means the cure for HIV may have been truly found using stem cell procedures.
"Stem cells are original cells that could be trained to do anything.So, it is possible to train them to attack HIV, which is probably what the German doctors have done," Jarikre said.
According to Jarikre, the result of the work by the German doctors would prove very useful for researchers working in both fields of stem and HIV/AIDS, adding that countries like Nigeria cannot be left behind on this.
"We are in a dynamic world where countries can no longer afford to hide under ignorance.We must watch out for further trials on this and see where we could tap in for benefit," he said.
HIV researcher at the University of Pennsylvania, Philadelphia, James Riley, also thinks that even though the technique has only been applied in one patient, the results are valuable.
"It is a tremendous proof of principle that if you can make the majority of your cells resistant to infection, you can really stop the virus," Riley said.
Meanwhile, Htter said that a different team of physicians intends to perform the same procedure in another HIV-positive patient with leukaemia.So, in a few years, the experiment may reach the next stage.
Whether the patient has been truly cured of HIV is, however, another matter that the report says remains unclear.
According to Nature, although the patient has gone about two years without a relapse, it is still possible that the virus will make a comeback.The virus could be lurking in cells that doctors have not been able to test, such as cells in the brain or heart.
What is, however, clear is that this is not a treatment most HIV-positive people would want to receive.The risks involved with a bone-marrow transplant far outweigh those that come with years of antiretroviral drug therapy, even considering the troublesome side effects of these drugs.Before receiving the transplant, recipients are conditioned with drugs and radiation to destroy their own blood-producing stem cells.The procedure leaves them vulnerable to infection, and there is also the possibility that their bodies will eventually reject the transplant.