Two men with HIV may have been cured after they received stem-cell transplants to treat the blood cancer lymphoma, their doctors announced today at the International AIDS Society Conference in Kuala Lumpur.

One of the men received stem-cell transplants to replace his blood-cell-producing bone marrow about three years ago, and the other five years ago. Their regimens were similar to one used on Timothy Ray Brown, the 'Berlin patient' who has been living HIV-free for six years and is the only adult to have been declared cured of HIV. Last July, doctors announced that the two men — the ‘Boston patients’ — appeared to be living without detectable levels of HIV in their blood, but they were still taking antiretroviral medications at that time.

Timothy Henrich, an HIV specialist at Brigham and Women’s Hospital in Boston, Massachusetts, who helped to treat the men, says that they have now stopped their antiretroviral treatments with no ill effects. One has been off medication for 15 weeks and the other for seven. Neither has any trace of HIV DNA or RNA in his blood, Henrich says.

If the men stay healthy, they would be the third and fourth patients ever to be cured of HIV, after Brown and a baby in Mississippi who received antiretroviral therapy soon after birth.

But Henrich and Daniel Kuritzkes, a colleague at Brigham who also worked with the men, caution that it is still too early know whether or not the Boston patients have been cured. For that, doctors will need to follow the men closely for at least a year, because the virus may be hiding out in 'reservoirs' — parts of the men’s bodies, such as their brain or gut, that can harbour the virus for decades.

“We’re being very careful not to say that these patients are cured,” Kuritzkes says. “But the findings to date are very encouraging.”

HIV researcher Steven Deeks of the University of California, San Francisco, says that doctors might need to wait at least two years before declaring that a cure has been achieved. “Any evidence that we might be able to cure HIV infection remains a major advance,” Deeks says. But, he adds, “there have been cases of patients who took many weeks off therapy before the virus took off”.

Exciting news

Still, researchers and doctors are excited about the news, especially because the Boston patients’ treatment differed from the Berlin patient’s regimen in one key way. Brown was given stem cells that were predisposed to resist HIV infection, because the donor happened to have a mutated version of a key protein — CCR5 — that is needed for HIV to infect cells. So Brown’s transplant was akin to gene therapy with HIV-resistant cells.

But the Boston patients received stem cells without the protective mutation. The transplanted cells must therefore have been protected from infection by the antiretroviral drugs taken during cancer treatment. Their doctors think that an immune response called graft-versus-host disease — a post-transplant reaction in which donated cells kill off a patient’s own cells — may have then wiped out the patients’ HIV reservoirs, potentially curing the men.

Transplant specialist Christine Durand of Johns Hopkins University School of Medicine in Baltimore, Maryland, says that the case of the Boston patients may show that current antiretroviral drugs are powerful enough, on their own, to protect the transplanted cells. “If cure has been achieved in the Boston patients, then it was the antiretroviral therapy, not gene therapy, that protected the donor cells,” she says.

The finding is very important for people with HIV who also need blood-cell transplants, but the treatment is unlikely to be used more generally because the risks from transplants are high. Durand says that Johns Hopkins is now revising its transplant procedures to keep people with both cancer and HIV on antiretroviral drugs during the transplant regimen.

Separately, the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Group, based in Silver Spring, Maryland, is trying to replicate the Berlin patient’s cure by giving CCR5-mutated HIV-resistant blood from umbilical cords to children and adults with HIV and cancer. 

Everyone with HIV could benefit from this work, researchers say, because it could yield valuable information about how to eliminate the HIV reservoir.

“We are still a long way off from a viable cure option for most patients,” Durand says. “But every step counts, and these cases can teach us important lessons.”

Interview with Dr. Alexiev Venelin.

Since when there is a procedure to remove teeth to derive stem cells?

In 2003, American scientists discovered that the pulp of milk teeth is a valuable source of biological mesenchymal stem cells that can be isolated and used cryopreservatеа treatment at a critical moment for the man. Scientific achievement is enormous. It's most popular method of extracting stem cells from the umbilical cord and placenta, add another one to the undeniable advantages. It gives parents a second chance, missed the first - to preserve stem cells at birth of their children. Today technology is successfully practiced in the U.S., UK, Greece and Bulgaria in two years.

How and what are the indications for extraction of milk teeth?

Milk tooth extraction is a safe, natural and completely noninvasive method for the extraction and storage of stem cells. Appropriate age from 5 to 12 years. For starters dentist tooth determine whether appropriate, inspection of front upper and lower teeth. Required tooth is with mild shaking.

It is the root to be fully preserved tooth so not only leaves fall and be removed as soon as it starts to shake. Before the operation is done or sectoral panoramic photograph to determine the condition of the tooth and its removal is performed under local anesthesia.
Remove the tooth is placed into a special set of transportation and transported quickly to the laboratory. The Bank tooth is examined to extract stem cells are stored at -196 C ˚. The entire process is accompanied by protocols to ensure the unique genetic material. Finally, the child's parents receive a certificate for successfully storing an initial period of 20 years.

Experts recommend extraction of two teeth, because the pulp of a tooth leads to storage of biological material a sample application. Medical logic leads to the more material you have, the more therapeutic applications are given.

Which of milk tooth are stem cells?

In milk tooth pulp in the accumulation of dentin formed hermetically sealed and sterile space, which contains multiple stem cells. The pulp of the tooth is formed even in the embryonic stage of development of the organism and therefore the cells are young and are carriers of the original DNA. It has been shown that the pulp of a tooth contains from 1000 to 100 thousand units stem cells that can be isolated to reproduce by cell cultures to be implanted in the area of ​​the lesion, giving rise to a new tissue.

What is the application?

Stem cells from milk tooth is defined as mesenchymal, which have the ability to differentiate into tissue-forming cells - heart muscle, kidney, liver, muscle, tendons, cartilage, have the ability to form dentin. Currently, the treatment of diseases through tissue regeneration by mesenchymal stem cells is the most recent and rapidly developing trend in modern medicine.

Research into stem cell therapy is rapidly evolving and offer hope for the treatment of juvenile diabetes, heart disease, arthritic disease, Parkinson's disease, Alzheimer's, spinal cord injury, multiple sclerosis and others. Japanese scientists have managed to create even new teeth in mice. All this is due to the ability of stem cells to differentiate into other cell types. Stem cells are the first motto of cells formed after fertilization, as these are the foundation of the dental pulp: mesenchymal, chondrocytes, osteoblasts and adipocytes.

The fact is that stem cells isolated from cord blood and placenta are much stronger and more numerous than any other. Since there are immunologically mature, they are able to transform into different types of blood cells, making a real alternative for the treatment of 80 types of diseases, including leukemia, disease and Hodgkin lymphoma, breast cancer and testicular multiple sclerosis , a number of neurological diseases and others.

Compared to undifferentiated cells derived from other tissue stem contained in the pulp of milk teeth, however, are very valuable because they reproduce faster, easier to differentiate into other cell types and can be extracted in many wider time range. But with aging stem cells slow their recovery and become much more efficient.

Therefore scientific theory is that the earlier draw, the more effective they will be in time.

Dr. Svetla Bogdanova, a specialist neurologist. He graduated in medicine in 1985 at the Medical University of Pleven, Bulgaria. In 1990 acquired specialty of neurology at the Medical University - Sofia, Bulgaria.

Passed courses and specializations in "Thermal burns" to MHATEM "Pirogov", "General EEG" at the Medical University - Sofia neurophysiology, "Doppler Neurosonology" at the Medical University - Sofia "Health Management" at the Medical University - Plovdiv. She has worked as head of the Regional Coordination Headquarters - Center for Emergency Medical Care, Sofia. He is currently a neurologist at Military Medical Academy and Medical Manager of Tissue stem cell bank "Biohelenika."

Really stem cells gives rise to the human body?

For the last 4-5 years in many international forums symposia and publications advocates topic of stem cells. Detailing their meaning and application. Each organ is composed of cells, such as liver is composed of hepatocytes, neurons of the brain, bone osteocytes, blood leukocytes and erythrocytes from lung pulmotsin etc. All these cells are highly specialized and differentiated function they perform. Stem cells are precisely those that develop in the earliest stages of embryonic development and have assigned a function to be performed. This is what is valuable. They have the original genetic material of an individual, not differentiated, ie the future is ahead of them and can be converted (transformed) into specialized cells of various organs. The most important thing about stem cells is that they are born the youngest cells, unaffected by external factors and aging. This is unique.

Is proven and diseases which are used?

Bone marrow transplantation was first performed in 1968 Bone marrow cells are used to treat patients diagnosed with leukemia, aplastic anemia, lymphoma, Hodgkin's disease, immune disorders, cancer. We know how is hard to find a suitable donor, how long to wait and how costly it. The decision to proceed with private banking (storage) of stem cells, so is the business organization and authorization of Biohelenika - stem cell bank, of which I am medical director. Modern medicine has come to the conclusion that everyone is good to have available their own stem cells.

Since 1988, stem cells from umbilical cord was successfully applied to replace the bone marrow. Stem cell transplants allow treatment of many serious diseases. This type of therapy have proven their undeniable advantage in the treatment of blood cancers - leukemia and lymphoma, is increasing. 107.3 to 100 thousand in 2005

Dr. Deborah Persaud of Johns Hopkins University today described the first documented case of a child being cured of HIV. The landmark findings were announced at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta, GA.

Dr. Persaud, an amfAR grantee, detailed the case of a two-year-old child in Mississippi diagnosed with HIV at birth and immediately put on antiretroviral therapy. At 18 months, the child ceased taking antiretrovirals and was lost to follow-up. When brought back into care at 23 months, despite being off treatment for five months, the child was found to have an undetectable viral load. A battery of subsequent highly sensitive tests confirmed the absence of HIV.

Confirmation of the cure was made possible by a grant the Foundation awarded to Dr. Persaud and Dr. Katherine Luzuriaga of the University of Massachusetts in September 2012. The grant allowed Drs. Persaud and Luzuriaga to establish a research collaboratory to explore and document possible pediatric HIV cure cases. The collaboratory includes renowned researchers Drs. Stephen Spector and Doug Richman at the University of California, San Diego; Dr. Frank Maldarelli at the National Cancer Institute; and Dr. Tae-Wook Chun at the National Institute of Allergy and Infectious Diseases.

"The child's pediatrician in Mississippi [Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi] was aware of the work we were doing, and quickly notified our team as soon as this young patient's case came to her attention," said Dr. Rowena Johnston, amfAR vice president and director of research. "Because the collaboratory was already in place, the researchers were able to mobilize immediately and perform the tests necessary to determine if this was in fact a case of a child being cured."

According to Dr. Persaud, comprehensive tests have confirmed beyond doubt that both mother and child were HIV positive when the child was born, and today no signs of HIV infection in the child can be detected by the most sensitive means available.

The only other documented case of an HIV cure to date remains that of Timothy Brown, the so-called "Berlin patient." In 2006, while on treatment for HIV, Mr. Brown was diagnosed with leukemia. His physician was able to treat his leukemia with a stem-cell transplant from a person who was born with a genetic mutation causing immunity to HIV infection. Following the transplant, Mr. Brown was able to stop HIV treatment without experiencing a return of his HIV disease.

This new case points to the tantalizing possibility that different populations of HIV-positive people might be cured in different ways. While Mr. Brown's case was the outcome of a complex, high-risk, and expensive series of procedures, this new case appears to have been the direct result of a comparatively inexpensive course of antiretroviral therapy.

"Given that this cure appears to have been achieved by antiretroviral therapy alone," said Dr. Johnston, "it is also imperative that we learn more about a newborn's immune system, how it differs from an adult's, and what factors made it possible for the child to be cured."

The Mississippi case also underscores the importance of identifying HIV-positive pregnant women, expanding access to treatment regimens than can prevent mother-to-child transmission, and of immediately putting infants on antiretroviral therapy in the event that they are born HIV positive.

"We are proud to have played a leading role in bringing this first pediatric HIV cure to light," said amfAR CEO Kevin Robert Frost. "The case is a startling reminder that a cure for HIV could come in ways we never anticipated, and we hope this is the first of many children cured of HIV in the months and years to come."