Stem cells transplant: hope for HIV patients?

Highlights

  • How Stem cells transplant aid in treating HIV patients
  • Origin of HIV
  • Development of various treatments for HIV
  • Inception and rise of Stem cell transplant
  • Mode of treatment and benefits of Stem cell transplant

 

 

Field of Medical science has always been dynamic, every day there are some new advancements that prove beneficial for mankind. Researchers around the world, work relentlessly to invent treatments that will counter ailments which are indeed deadly. One such form of treatment that has been instrumental towards curing numerous serious diseases is Stem cell transplant.

In a latest advancement, stem cells transplant has managed to cure second HIV patient as stated by researchers from United Kingdom. HIV Aids, one of deadliest diseases around the world has always been considered incurable. Previously in year 2007, first patient was cured of HIV by similar sort of stem cell transplant.

 

 

Origin of HIV AIDS

It was the year 1930, when the world came to know about Human Immunodeficiency Virus (HIV). Scientists claim that this virus has originated from Chimpanzees belonging to West Africa and got transferred to human beings via blood during hunting. In year 1999, researchers found that a strain of chimpanzee SIV known as SIVcpz, that was extremely similar with HIV. The scientist also found that chimpanzees that eat and kill red-capped mangabeys and greater spot-nosed monkeys, the smaller monkey species usually get infected with strains of SIV, resulting that those two strains in SIVcpz and can easily get spread through humans and chimpanzees. Researchers also think that first SIV to HIV happened in Kinshasa, the capital of Congo.

HIV virus basically attacks CD4 cells resulting into damage of immune system and is usually transmitted through bodily fluids such as blood, semen, vaginal fluids, anal fluids, and breast milk also. Since ages it has been proved that HIV mostly spreads by indulgence in unprotected sex, along with birth and infected needles.

In the course of time this virus attacks CD4 cells in order to make body weak and cannot fight infections and diseases, ultimately leading to the most severe form of an HIV infection that is acquired immunodeficiency syndrome more commonly known as AIDS. The individual suffering from AIDS has extremely weak immune system and can easily get infected by various diseases, right from Pneumonia to dreadful Cancer.

It was the year 1984, when researchers found the real cause of AIDS—the HIV virus—and it was Food and Drug Administration (FDA), who licensed the first commercial blood test for HIV in 1985.

Comparatively today, there are many kind of tests that are helpful in detecting HIV, as a part most of them are successful in detecting HIV antibodies. All these tests can be performed with one’s blood, urine or saliva as these thing have higher traces of HIV antibodies.

Actor Rock Hudson was the first guy from high society to die from AIDS. In order to restrict HIV getting into blood banks, numerous regulations were brought in, one of them being prohibition of blood donation by gay men courtesy of FDA. Until year 2015, rules were changed in order to allow gay men to donate blood. More than 20,000 cases of AIDS were reported all across the world.

 

Development of Azidothymidine (AZT)

Azidothymidine (AZT) was first antiretroviral medication for HIV and was invented in year 1987. Today we have many other medications for HIV which are currently available, and are usually utilized together in antiretroviral therapy (ART) or highly active antiretroviral treatment (HAART).

This therapy works by prevention of virus getting multiplied, which grants the immune system a chance to recover and tackle the infections along with HIV-related cancers. This procedure is highly important to keep child safe from HIV, when it is inside the womb. This has been crucial in terms of saving the infant from this deadly disease and is considered landmark achievement.

The World Health Organization (WHO, declared December 1st to be World AIDS Day in the year 1988. Despite the amount of awareness, there were hike in number of reported cases of AIDS by 100,000 in country of U.S itself, while WHO estimated that there were 400,000 AIDS cases worldwide at the end of decade.

 

 

Development of various treatment towards HIV

The year 2001 witnessed emergence of generic drug manufacturers that began selling patented HIV drugs to developing countries at comparatively lower price, which made numerous pharmaceutical companies bring down prices of their HIV/AIDS medicines. Immediately next year, reports by the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that AIDS was numero uno reason of fatalities in the continent of Africa.

In following years, specifically in 2006, the researchers found that the risk of female to male HIV transmission can be brought down to 60 percent by method of penile circumcision. This was largely accepted by gulf countries as it was stated in Islamic cultures for men to perform circumcision. While all developing countries have also considered that circumcision cuts down the risk of transmission.

Ban related to prohibition of entry of HIV patients in United States that was imposed in 1987 was lifted in year 2009. In 2012, approval of pre-exposure prophylaxis, or PrEP, for HIV-negative people was given by FDA. The main purpose of PrEP, was that it can reduce the threat of HIV occurring from sex by more than 90 percent and also from intravenous drug use by 70 percent, if taken on regular basis, was stated by CDC. A study that was concluded in year 2019, came up with conclusion that around 750 gay men who were on anti-viral treatment failed to transmit any viruses to their partners.

At the beginning of 2018 saw some 36.9 million people infected with HIV/AIDS worldwide, and more than 940,000 fatalities from AIDS that year itself, were stated by WHO. Africans from Sahara region dominate the number of HIV cases as they are around 70 percent of world HIV population.

Inception and rise of Stem cell transplant

Stem cells have been linked with bone marrow and hence it takes us back to first bone marrow transplant, that took place in year 1958 by French oncologist named as Georges Mathe. This transplant treatment was demonstrated on 5 nuclear workers from Yugoslavia as their own bone marrow was damaged by accident at Vince nuclear institute. Georges Mathe is stated as pioneer of bone marrow transplant as he culminated this treatment in curing leukaemia.

Further Nobel Prize awardee E. Donall Thomas brought forward process of Stem cell transportation with the help of bone marrow stem cells, where his work showcased how bone marrow that are infused intravenously could increase the number of new bone marrow and blood cells. This work was key reason behind him getting awarded by Nobel Prize in the field of Physiology and Medicine as it played huge role in reduction of dreadful complication known as graft-versus-host-disease. In a collaboration with Prof. Eloise Giblet of University of Washington, he found genetic markers which aided in confirmation of matching donors.

 

Different types of Stem cell transplant

There are various types of stem cell transplants. Depending on illness or patient’s condition, they can receive their own or another person’s hematopoietic stem cells. In an allogeneic transplant that means transplant from another individual, the patient receives stem cells from a family member, generally a parent or sibling or unrelated donor who has group of proteins expressed on the surface of white blood cells called human leukocyte antigen (HLA), similar with patient. The collected stem cells are drawn from donor’s bloodstream or bone marrow to be specific. Umbilical cord blood collected from the umbilical cord after a baby is born can also be considered another source of stem cells.

While in autologous transplant, where the patient receives his or her own hematopoietic stem cells, which are usually drawn from his own blood stream or bone marrow. This kind of transplant is kept reserved for treatments like cancer.

 

Selection process of Stem cell donor

Selection of donors is made on the amount of similarity of their human leukocyte antigen (HLA) with the patient. When in kids, the markers are specifically made in order to get right amount of HLA protein from each parent that too in right proportion. Hence family member are ideally considered for being the donor as there are higher chances of similarities with the patients in terms of HLA

In case of HLA mismatch, the potential donors are searched with the help of National Marrow Donor Program (NMDP) Registry.

Generally, the HLA matching brings in great chances of donor stem cells engrafting or finding their way into the recipient’s bone marrow, resulting into production of circulating blood cells in patient’s body. This further brings in making HLA-matched stem cells helpful in reducing the risks of complications that are associated with stem cell transplant.

Other factors for donor selection are age, gender, infection exposures, and overall donor health.

 

Ideal state to opt for Stem cell transplant

Generally there is an ideal state or time for indulging into stem cell transplant. In order to determine this, it is necessary to check health of patients body whether it is capable for going through the treatment or not. Along with all physical aspects, it is important to check some other issues if the patient has malignant tumors in his body.

The evaluation process that a potential transplant recipient undergoes to assess organ function and malignant disease response prior to transplant is called the “pre-transplant work-up.” Transplant coordinators work with patients and families in identifying a donor and setting up the necessary testing needed to determine if a patient is ready to receive a transplant.

 

Benefits of Stem cell transplant

Various advancements of stem cell transplant treatment has been instrumental in the field of regenerative medicine. When it comes to damaged stem cells, these transplant has helped to recover damage. Stem cell transplants have also aided in recovery of kidney damage along with urinary tract infections. Different sorts of studies have proved that the patients remained free from systemic lupus erythematosus (SLE) and shown great improvement. This stem cell transplant is usually also used in the treatment of leukemia and lymphoma.

 

Role of Stem cell transplant in treating HIV AIDS

Years back in 2007, doctors from the city of Berlin, Germany along with Gero Hutter, a German hematologist performed stem cell transplant of patient named Timothy Ray Brown, a HIV patient who was suffering from leukaemia.  After going through various matches for the right stem cells, these doctors selected two genetic copies of cell surface receptor’s unique or rare variant. This cell was able to block the attachment of HIV with cell and proved resistant towards it. After conducting stem cell transplant, almost three years later there were no sign of HIV in patient’s blood and tissues along with reduction of HIV anti-bodies and was speculated to be cured from HIV.

In the current case where the HIV patient was cured with the help of stem cell transplant, go the cells which did not have CCR5 gene that helps virus grow by providing it protein. The patient went through stem cell transplant in order to get rid of Hodgkin Lymphoma and was infused with stem cell without CCR5 as part of bone marrow transplant treatment. After almost two and half years of bone marrow transplant and no antiretroviral therapies, doctors stated that there were no traces of HIV in blood samples. Along with blood samples the HIV was undetected in lymphoid tissue, semen, intestinal tissue and cerebrospinal fluid.

 

 

Conclusion

HIV and AIDS kill almost 1.1 million people annually. Various researchers are working on daily basis to find a cure for this dreadful ailment. The fact of second HIV patient getting cured by stem cell transplant brings in some amount of hope for all the people suffering from HIV around the world. Stem cell transplant have been treating various diseases since ages and is indeed safer compared with numerous other treatments. This latest advancement can prove path breaking in medical science and will surely bring in some insights over treatment of some other diseases.

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