I was just about to say the same thing, but you summarized it well so I'll only add this: a bone marrow transplant could work for a small number of HIV patients, but it's not a cure for everyone. In order to work, tissue-matched donor must be found that is also HIV-resistant. It's very hard to find an appropriate donor (odds are very tiny) and only 1% of those you find will be resistant. I would guess you would have to screen between 1 and 100 million people to find a HIV-resistant tissue-matched donor. Then, that donor has to be willing to donate. Even then, there are other significant potential complications from the transplant and later rejection to deal with.In order for a virus to infect a cell it first needs to get into that cell. HIV and a lot of other viruses accomplish this by first binding to a receptor found on the surface of the cell. If they cannot do this initial attachment, they can't infect the cell. That's why there are diseases that are species-specific - a virus that only infects dogs can't infect non-canines because other species lack that receptor on their cells. The 1% are immune because they lack this receptor. Thus this guy got a rebooted immune system from the bone marrow transplant that lacks this receptor, meaning his HIV could not infect any more T-cells.What I want to know is....if 1% of the white population is, in fact, immune to HIV, why in the HELL are the drug companies not working with that to try and produce a vaccine???I had no idea that a small percentage of people were immune.
A bone marrow transplant means the eradication of your current blood-producing marrow, so it effectively eliminates your immune system for a while. Most HIV patients have all kinds of diseases, and eliminating their immune system for a short time would be extremely dangerous. Additionally finding an immune donor who is a good match (rejection) would be difficult, making this procedure impractical for most cases. Most people are only good matches with siblings.
Finally, HIV is an RNA virus that mutates quickly, meaning it's very difficult to come up with a workable vaccine against it.
A much more likely cure might be to remove some hemopoetic stem cells from the HIV patient, disable the gene for the HIV receptor through genetic recombination (gene therapy) and then use that for an autologous transplant. This approach is not trivial, and there are still significant risks, but it's more likely to work and more practical.
Everybody I just quoted is right, I just figured I'd add my $0.02:
Transplant patients need to be immunosuppressed for the rest of their lives, thus leading to higher mortality from cancer and from opportunistic infection. The thirty-year mortality is around 20%, and that's for patients who survived their first five years. (Granted, mortality rates may be lower for people getting transplant nowadays, but we won't be sure of that for years to come.) The morbidity (development of long-term chronic problems that decrease quality of life) is also very high. Even with a matched donor, allogeneic BMT isn't a practical cure for HIV at all.
Granted, Medscape's not the best source to be quoting from, but here's a link discussing the long-term issues with BMT for non-HIV-infected patients:
http://emedicine.medscape.com/article/989518-overview
