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# Doctors Will Test Gene Editing On HIV Patients

#### kdawson posted more than 5 years ago | from the importing-mercenaries dept.

263

Soychemist writes "Some people have a mutation that makes them highly resistant to HIV, and scientists think that they can give that immunity to anyone with a new type of gene therapy. The first human trials will start at the University of Pennsylvania this week. Researchers will draw blood from people with drug-resistant HIV, clip the CCR5 gene out of their T-cells with a nuclease enzyme, grow the modified cells in a dish, and then return 10 billion of them to the patient's bloodstream. Those cells will be immune to the virus, and they will keep the patient's T-cell count up even if the rest are destroyed. 'We will see if it is safe and if those cells inhibit HIV replication in vivo,' said the lead researcher. 'We know they do in the test tube.'"

### might as well guinea pig at that point (5, Insightful)

#### Clover_Kicker (20761) | more than 5 years ago | (#26721077)

What's the worst that could happen, they screw it up and you die?

### Re:might as well guinea pig at that point (5, Insightful)

#### LaskoVortex (1153471) | more than 5 years ago | (#26721091)

What's the worst that could happen, they screw it up and you die?

Or they could not treat you and you'd die.

### Re:might as well guinea pig at that point (5, Funny)

#### RelaxedTension (914174) | more than 5 years ago | (#26721209)

Or you volunteer, and be the one to get the placebo.

### Re:might as well guinea pig at that point (4, Insightful)

#### ThrowAwaySociety (1351793) | more than 5 years ago | (#26721457)

Or you volunteer, and be the one to get the placebo.

In which case, you are no worse off, and at least get careful observation and conventional treatments for your symptoms.

### Re:might as well guinea pig at that point (-1, Redundant)

#### Anonymous Coward | more than 5 years ago | (#26721493)

Either way, if you ask me, firstly suggesting this idea, and just hatching a plot like this to combat this disease is simply amazing!

It's one of the best things I have read today.

### Re:might as well guinea pig at that point (1, Interesting)

#### Fluffeh (1273756) | more than 5 years ago | (#26721495)

Whoops, that's me there, hit AC by mistake.

### Re:might as well guinea pig at that point (2, Interesting)

#### Anonymous Coward | more than 5 years ago | (#26721957)

+1, Interesting? Really?

You kids today. You make karma whoring too easy.

### Re:might as well guinea pig at that point (1, Interesting)

#### Anonymous Coward | more than 5 years ago | (#26722049)

I want to mod it interesting now just to spite you.

### Re:might as well guinea pig at that point (0)

#### Anonymous Coward | more than 5 years ago | (#26721099)

Hope not, that would mean no more Slashdot :(

### Re:might as well guinea pig at that point (4, Funny)

#### linhares (1241614) | more than 5 years ago | (#26721295)

Hope not, that would mean no more Slashdot :(

You must be old here.

### Re:might as well guinea pig at that point (1)

#### areusche (1297613) | more than 5 years ago | (#26721103)

Will Smith becomes the last human to save humanity from CGI super demons?

### Re:might as well guinea pig at that point (4, Funny)

#### binarylarry (1338699) | more than 5 years ago | (#26721635)

CGI super demons... who cannot be stopped by AIDS alone.

### Re:might as well guinea pig at that point (5, Insightful)

#### Anonymous Coward | more than 5 years ago | (#26721167)

This is what we need. Medicine is far too conservative in so many cases. Death would be a welcome accident in many diseases of terminal illness. Not saying the patient shouldn't decide, but they should certainly have the option to try experimental treatments if they want.

### Re:might as well guinea pig at that point (3, Insightful)

#### MichaelSmith (789609) | more than 5 years ago | (#26721363)

This is what we need. Medicine is far too conservative in so many cases.

I think we need more engineers involved in Medicine, particularly on the implementation side. I wish I could point to this but I remember reading about a scientist who had invented something quite revolutionary who spent the next seven years rebuilding his machine to be small enough for general use. That is the kind of job which should be given to an engineer, but it won't keep the scientist employed.

### Re:might as well guinea pig at that point (1)

#### CodeBuster (516420) | more than 5 years ago | (#26721485)

Experimental treatments are already available to HIV patients who wish to try them and have been for years now. The FDA loosened the rules on that back in the early to mid 1990s because of the growing epidemic and terminal nature of the illness. Although in recent years the consequences of experimental treatment have to be weighed against the known efficacy of the anti retro viral cocktails that are now available and manage the infection quite well (albiet with some moderate to severe side effects). Should a patient be able to risk a premature demise with experimental treatment when their prognosis on HAART is good? If they are not insane then the answer is probably yes, but any ethical doctor would probably recommend, at the very least, serious reflection and possibly some sort of third party counseling before signing up their patients on a first request.

### Re:might as well guinea pig at that point (4, Informative)

#### beav007 (746004) | more than 5 years ago | (#26721617)

Not to be a wet blanket for your argument, but this is being tried on drug-resistant HIV patients.

### Re:might as well guinea pig at that point (1)

#### KungFuSoi (315593) | more than 5 years ago | (#26721927)

just as in cancer or other infectious diseases, the natural selection placed on the hiv population within the patient by therapy (haart) will make it likely for the emergence of drug-resistant strains. thus, even patients who do not have drug-resistant strains of hiv will benefit if this therapy is a success.

of course, one cannot be sure that the selection pressure exerted by the t-cells with the ccr5 (\delta 32?) deletion will not result in hiv strains capable of invading t-cells via a new mechanism.

### Re:might as well guinea pig at that point (0)

#### Anonymous Coward | more than 5 years ago | (#26721183)

What's the worst that could happen, they screw it up and you die?

Fuck you, my friend died from AIDS you insensitive clod.

### Re:might as well guinea pig at that point (1, Funny)

#### Anonymous Coward | more than 5 years ago | (#26721199)

Mr. Wozniac? Is that you?

Probably shouldn't mention it at the next keynote, then.

### Re:might as well guinea pig at that point (-1, Offtopic)

#### Anonymous Coward | more than 5 years ago | (#26721335)

i see wat u did their

### Re:might as well guinea pig at that point (0, Redundant)

#### lee1026 (876806) | more than 5 years ago | (#26721189)

The worst that can happen is that they screw up and you die much sooner then you otherwise would.

### Re:might as well guinea pig at that point (-1, Flamebait)

#### BlueParrot (965239) | more than 5 years ago | (#26721197)

Don't mod that insightful you ignorant clods. With modern antiretroviral drugs HIV positive patients can live for decades. As a consequence complications from a gone-wrong tinkering with the immunity system could very well decrease the patient's quality of life and/or life expectancy. Not saying it is not worth trying under trials with the usual checks and safeguards, but suggesting that somebody HIV positive "is dead anyway" is just nonsense. We are all going to die sooner or latter, but I presume that doesn't mean you want to volunteer for every type of medical testing there is?

### Re:might as well guinea pig at that point (5, Informative)

#### Mauzl (1312177) | more than 5 years ago | (#26721229)

If you RTFA, its people who have drug-resistant HIV who are being experimented on.

### Re:might as well guinea pig at that point (1)

#### bruno.fatia (989391) | more than 5 years ago | (#26721281)

You can't really blame him for not reading the article.. this is slashdot afterall.

### Mod parent down - didn't RTFA (4, Informative)

#### LonghornXtreme (954562) | more than 5 years ago | (#26721259)

The test subjects have drug resistant HIV.

### Re:Mod parent down - didn't RTFA (1, Informative)

#### powerspike (729889) | more than 5 years ago | (#26721449)

This isn't a drug, they are modifying the cells in such a way that the virus can't attach to them. Drugs genneraly add items into a body to counter an item, this is modifying the immune system directly itself, something that hasn't be done before. the CCR5 gene apparently is why around 50-60% of the English population survived the black plague in the dark ages, when the mortally rate in people without it is over 95%.

There are a lot of deadly viruses that could be cured by this.

### Re:might as well guinea pig at that point (-1, Redundant)

#### Anonymous Coward | more than 5 years ago | (#26721277)

With modern antiretroviral drugs HIV positive patients can live for decades

For those people too lazy to RTFS allow me to emphasize:

from people with drug-resistant HIV,

### Re:might as well guinea pig at that point (4, Insightful)

#### dunezone (899268) | more than 5 years ago | (#26721289)

Yeah, those modern anti-retroviral are not so perfect though. Most of them are combo drugs which means you take multiple pills at a time. As a result of that the side effects can be extremely painful and dangerous. And I know, its better then death if you don't take them but finding a better alternative is a must. These drugs are expensive and the majority of individuals who have HIV don't have access to these them.

And just like anti-bioitics. After a certain period of time these drugs become ineffective. Hell, if you start missing doses or cant afford them it could easily be game over.

The people in these studies are failing current treatment methods. There is nothing left at this point.

### Re:might as well guinea pig at that point (5, Insightful)

#### TubeSteak (669689) | more than 5 years ago | (#26721647)

These drugs are expensive and the majority of individuals who have HIV don't have access to these them.

Those drugs are expensive in (mostly Western) countries that kowtow to pharmaceuticals and have not stood up and supported generics.

India was the first country to start cranking out generics and is probably the sole reason that Big Pharma dropped prices from $10,000~15,000 per year to less than$1,000 on what are now considered second-line drugs.

Generics were the only thing pulling down insane prices and the USA's response was to setup TRIPS (Trade-Related Aspects of Intellectual Property Rights) which enormously complicated the process of issuing compulsory licenses.

Off the top of my head: India, Brazil, Thailand and South Africa have all issued compulsory licenses for AIDS drugs.
AFAIK, Thailand and Brazil are the only two countries to do so post-TRIPS.

In response to Thailand's compulsory license, the price of one drug dropped by half for many other developing countries. OTOH, a major pharmaceutical said they wouldn't be applying for licenses to sell new drugs in Thailand... and the USA put Thailand on a watch list of countries considered to be committing intellectual property theft. So it was something of a Pyrrhic victory for Thailand.

Long story short: Big Pharma's bottom line is getting in the way of preventing major health catastrophes in developing countries.

### Re:might as well guinea pig at that point (1)

#### aussie_a (778472) | more than 5 years ago | (#26721999)

These drugs are expensive and the majority of individuals who have HIV don't have access to these them.

But goddamnit! You won't be having any of that socialised medicine in your country! If people can't afford treatment, they deserve to die!

### Re:might as well guinea pig at that point (3, Interesting)

#### tjstork (137384) | more than 5 years ago | (#26721349)

With modern antiretroviral drugs HIV positive patients can live for decades

Have you looked at federal expenditures on medical care lately? Let's face it, with skyrocketing costs of all of these medical treatments, we're going to need to rethink who lives and who dies, particularly when it comes to preventable diseases that are hideously expensive to treat.

HIV, lung cancer, some forms of heart disease, ultimately, people will just have to be made comfortable unless they plan on paying for their medical care themselves. It would be one thing if people got insurance for HIV and lung cancer through private insurers who accepted the risks, but, once all taxpayers have to accept that risk, well, its an entirely different contract.

In that sense, this new genetic treatment is the shape of things to come, where the government experiments on treating on some people with some new drug, because, they aren't going to get anything else.

### Re:might as well guinea pig at that point (1, Interesting)

#### Anonymous Coward | more than 5 years ago | (#26721471)

I'm sure your stance would change if you were someone who was in need of treatment and didn't have the appropriate medical insurance.

I think the real problem is the outrageous cost of treatment. Some drugs being manufactured have higher marketing costs then they do for research.

Anyway, you seem to have a rather callous view on who should or shouldn't get treatment and I think its deplorable. Your tax dollars pay for far many things that I believe most people would agree that they are not necessary, and I think that its justifiable to pay for treatment for those who need it.

If your are ever yourself stuck in a situation where you could not afford adequate treatment for health care, though I wish this never happens to you or anyone else for that matter, then I hope you remember what you said in your post.

### Re:might as well guinea pig at that point (4, Insightful)

#### tjstork (137384) | more than 5 years ago | (#26721695)

I'm sure your stance would change if you were someone who was in need of treatment and didn't have the appropriate medical insurance.

Probably would. But the way I see it now is, I smoke, I've smoked for 20 years, and I'm starting to get the first reduced lung function and I should quit but probably won't and I'll die from it, dragging myself and the rest of society down for a million bucks in chemo and treatment. What's up with that? Why should I keep 50 kids out of college because I was a dumbass? That's not right. Same thing with HIV. For the most part, you can prevent HIV. You can stay monogamous as much as you can. Don't be a slut, and use a rubber. Don't use needles. Sometimes you have to think about what your impact is on society.

I think the real problem is the outrageous cost of treatment. Some drugs being manufactured have higher marketing costs then they do for research.

Maybe the stuff is expensive because it is, well, actually complicated to research, make and produce. Science is a craft and crafts are expensive. I don't doubt that the workflow in a pharma company is probably retarded, and that makes it more expensive, but, at the same time, the problem is really that all the knowledge is completely new, so there's no automation in any of the research. It's not like McCoy can just drop a blood sample into the computer and whip up a batch of cure.

Anyway, you seem to have a rather callous view on who should or shouldn't get treatment and I think its deplorable.

That's Democracy. If you want to have private health insurance, have private insurance. Otherwise, accept that, there's going to be people who will make the argument that we should not blow too much medical money on sufferers of illnesses resulting from lifelong self indulgence or excessive risk taking.

### Re:might as well guinea pig at that point (4, Insightful)

#### daveime (1253762) | more than 5 years ago | (#26721511)

No, the only thing we need to rethink is how the pharma companies can ever justify selling a medication that costs \$200 for a single dose.

You know, Chris Rock summed it up nicely. No one will ever cure AIDS, the money isn't in the cure, it's in keeping you alive and helping you live with it. Just get your "fix" and live for one more day.

#### MichaelSmith (789609) | more than 5 years ago | (#26721339)

Tyrell: The facts of life. To make an alteration in the evolvment of an organic life system is fatal. A coding sequence cannot be revised once it's been established.

Roy: Why not?

Tyrell: Because by the second day of incubation, any cells that have undergone reversion mutations give rise to revertant colonies like rats leaving a sinking ship. Then the ship sinks.

Tyrell: We've already tried it. Ethyl methane sulfonate as an alkylating agent a potent mutagen It created a virus so lethal the subject was dead before he left the table.

Roy: Then a repressive protein that blocks the operating cells.

Tyrell: Wouldn't obstruct replication, but it does give rise to an error in replication so that the newly formed DNA strand carries the mutation and you've got a virus again. But, uh, this-- all of this is academic. You were made as well as we could make you.

copied from here BTW [trussel.com]

### Re:might as well guinea pig at that point (1, Funny)

#### Anonymous Coward | more than 5 years ago | (#26721355)

What could go wrong? Barclay's Protomorphosis Syndrome [memory-alpha.org] .

### CANCER (1)

#### Noirling (1468781) | more than 5 years ago | (#26721413)

Hmm. Uncontrolled cell reproduction after the T-cells are replaced? In other words, cancer. Anybody know what happens to a person when they have too many T-cells? Do you become super immune to everything? How can you get rid of t-cells quickly if you have to?

### Re:CANCER (5, Informative)

#### Wain13001 (1119071) | more than 5 years ago | (#26721585)

For the most part, T-cells die off naturally.
People infected with HIV do not have to deal with a problem of too many t-cells, so in this case it's not much of a concern.

Most importantly though, T-cells do not replicate to create more T-cells. They come from a type of lymphocyte starter cell (a stem cell essentially), which reproduces in the bone marrow.

Taking t-cells from your body, and then reintroducing them to your body will not give you leukemia (literally meaning "White Blood", refers to various cancers of white blood cells).

More than likely this is just a test, not *the cure*. The point being to see if the modified t-cells survive long enough to keep the count from dropping (as it would via a normal HIV infection). If it does work, then we can start developing methods to modify bone-marrow in order to make the new t-cells your body creates have the altered gene.

Of course, I'm not an expert, and the article is unfortunately slim on details, so this is basic speculation.

### Re:CANCER (0)

#### Anonymous Coward | more than 5 years ago | (#26721723)

with too many T-cells, there's probably (me not am expert) a heightened risk that your immune system will attack your own body.

I had a friend whose immune system attacked her nervous system. Forget the name of the disease but she missed a whole year of high school while being rehabilitated with physical therapy.

### Re:might as well guinea pig at that point (5, Funny)

#### jsse (254124) | more than 5 years ago | (#26721697)

What's the worst that could happen, they screw it up and you die?

You'll lose all your body hair; become a human-biting-albino that're very sensitive to sunlight; start biting humans and then turn them into your kind; you'll keep your biting until the T-virus in your body because air-bourne infecting disease, when you'd find no human alive for you to bite.

I didn't mean it'd happen, but since you asked for the worse...

### Re:might as well guinea pig at that point (0)

#### Anonymous Coward | more than 5 years ago | (#26721797)

I don't particularly mind this. As long as they don't come one day and say: "We've got a bad news and a bad news, the bad news is we made a deadlier HIV, the bad news is that it got released in the wild."

### Re:might as well guinea pig at that point (1)

#### aussie_a (778472) | more than 5 years ago | (#26721955)

Here's the thing. They've done all the research they can to test this without using it on humans. All the research indicates that this works.

So we've got a choice. Not test it on humans and allow HIV to continue to spread uninhibited. Test it on humans and possibly find a way to make people less likely to contract HIV.

You seem to suggest we stick with option 1. I'm glad someone is willing to go with option 2.

### Re:might as well guinea pig at that point (0)

#### Anonymous Coward | more than 5 years ago | (#26722043)

This is what WILL happen, not what MIGHT happen, as with concerns that the LHC MIGHT create black holes. No, I'm not talking about what MIGHT happen, I am talking about what WILL happen. They will do this gene mutation test thing. They'll test it on 100 people who are about to die from AIDS. They'll be instantly cured. The whole world will jump for joy in celebration. Then it will be what happened in the movie I Am Legend. The people who received the treatment will suddenly turn into insane monsters and it will be highly contagious. Within three years, the entire world, except a very small percentage who are immune for some reason, will have turned into these monsters. Most of the immune people will be eaten by these monsters. The monsters will come out at night and go into hiding during the day. That's not what MIGHT happen as a result of these treatments. That's what WILL happen. I guarantee it. Everyone's talking about how 2012 will be the end of the world. It's because that's three years from now, three years from the date this treatment begins. We're all going to die.

### Top ten least manly ways to die (-1, Offtopic)

#### Reikk (534266) | more than 5 years ago | (#26721079)

Top ten least manly ways to die: 10) Choking on strudel. 9) Waltzing off the edge of the Empire State Building. 8) Being mauled by the Easter Bunny. 7) Flushing yourself down the toilet. 6) Tripping on your own dress tail, falling down one stair. 5) Nicking yourself while shaving your legs. 4) Killer Canary. 3) Severe paper cut. 2) Killed in kickboxing match with Johnny "No Legs" Johnson. 1) Crocheting accident.

### Ha! (0)

#### Anonymous Coward | more than 5 years ago | (#26721083)

This day has finally come.

### It's about time ... (0)

#### Anonymous Coward | more than 5 years ago | (#26721109)

now I can go back to having anonymous sex at the local sexatorium. Mmmm glory holes....

### Re:It's about time ... (1, Funny)

#### Anonymous Coward | more than 5 years ago | (#26721263)

be careful dude. I got a cigarette burn on my dick from some cocksucker on the other side of a glory hole.. Try explaining that to your wife.

### Cost (0)

#### Anonymous Coward | more than 5 years ago | (#26721127)

What might modifying your DNA actually cost, efficiencies of a mature process taken into consideration?

### wait.... (0, Troll)

#### ndik (1186119) | more than 5 years ago | (#26721131)

Wait! Let me grab my gardening scissors to cut that gene out, oh.. we actually need proper medical equipment? I thought we're talking about HIV here.

### Sounds expensive... (-1, Troll)

#### The Master Control P (655590) | more than 5 years ago | (#26721147)

I think not shooting up meth and then not going on all-night-long no-condom buttfucking sprees is cheaper, so I'll go with that.

### Re:Sounds expensive... (1)

#### Idiomatick (976696) | more than 5 years ago | (#26721157)

I guess they didn't have sex ed when you were in school.

### Re:Sounds expensive... (1, Funny)

#### Anonymous Coward | more than 5 years ago | (#26721227)

Let's not besmirch the guy's education. I'm sure they had sex-ed when he was in school, but you know how it is - if you never make use of something you soon forget it.

### Re:Sounds expensive... (5, Informative)

#### dunezone (899268) | more than 5 years ago | (#26721223)

Every time someone posts about HIV we get a jackass like you. There are people who have HIV and didnt contract it through sex or drugs.

There are people who were born HIV+ because their mother was a carrier, there are people who have been raped and now carry the virus, there are people in the medical field that contract it because some drug addict freaks out while they tend to them. Hell, even though we test blood now many people contracted it through blood transfusions before they tested it.

Oh and by the way. Condoms don't give 100% protection against HIV its about 80-85%.

HIV is a bastard of a virus. Our immune systems can usually handle most viruses without intervention. You cant win on your own against HIV. It will destroy the immune system eventually.

If this treatment is successful at this level. At least we can give life to those who didn't have the choice.

### Re:Sounds expensive... (0)

#### Anonymous Coward | more than 5 years ago | (#26721553)

Unprotected sex with an HIV positive partner hs an infection rate of only about 1 in 2000. Throw a condom into that mix and you are pretty much good to go.

### Re:Sounds expensive... (1)

#### db32 (862117) | more than 5 years ago | (#26721701)

I only wish I had the mod points to give you for this one. However, there are is still a fairly wide variety of viruses that we aren't equiped to handle without vaccinations and the like, but all in all HIV is definitely a hell of a bastard. It stuns me to see the level of ignorance displayed regarding HIV at times. The treatment Ryan White recieved before his death was reprehensible due to ignorant shits. Testing of blood transfusions before that were basically unheard of. To this day I don't know if I am more disgusted by the homophobic bullshit or the mind boggling scientific ignorance that lead to the treatment he recieved.

### Re:Sounds expensive... (2, Insightful)

#### Xenna (37238) | more than 5 years ago | (#26721765)

HIV is a bastard of a virus. Our immune systems can usually handle most viruses without intervention. You cant win on your own against HIV. It will destroy the immune system eventually.

HIV is a bastard because it's relatively benign and very hard to transmit. A normal deadly virus like Ebola kills you quickly, HIV keeps you healthy and able to infect others for years. It's mainly transferred by sex, which is a big bummer for all of us who like to sleep around which includes lots of gay men.

But once you have it, you won't get rid of it. Nothing special either, because most people live with the chicken pox virus for most of their lives. That usually doesn't kill you, though...

X.

### Re:Sounds expensive... (-1, Troll)

#### Anonymous Coward | more than 5 years ago | (#26721517)

yeah, and I've also heard that HIV turns your skin black. That's why I just can't trust Barrack Obama as president. He clearly lied about his health, and now we need to know the truth about his buttfucking meth addiction!

You don't say.

### Science delivers (-1, Troll)

#### Mauzl (1312177) | more than 5 years ago | (#26721169)

Yet I know people will think this is evil because its 'playing God' and 'saving fags'. Hell, Fred Phelps is probably making signs already...

### MOD PARENT UP! (-1, Troll)

#### Anonymous Coward | more than 5 years ago | (#26721401)

He attacked the religious freaks! Great move! By the rules of /., that's +5 insightful!

### Price Tag? (4, Interesting)

#### Anonymous Coward | more than 5 years ago | (#26721177)

Hopefully the researchers are successful in their endeavours but you've got to wonder about the costs associated with such a procedure. With something like a 33 million estimated people infected with HIV world-wide I wonder what percentage would actually be able to afford treatment :/

### Re:Price Tag? (1)

#### kiwijapan (1293632) | more than 5 years ago | (#26721845)

As with any new technology, there's going to be a large cost involved with the development and research in the early stages.

Reading the article, it seems that the patient can only receive their original T-cells, but with enough experimentation and development, it may be possible to create a 'generic' T-cell that is close enough to natural T-cells to be accepted by anyone's body.

If this is achieved, then it's just a matter of mass producing the 'generic' T-cell. It might even be possible to create a 'generic' T-cell that causes a mutation in the CCR5 cell in existing T-cells to render those cells inactive, which means that only a small amount would be needed per person.

If we can advance the process this far, the only remaining problems would occur with patients or people being innoculated who have naturally occuring mutations or extreme differentations in their T-cells that prevent the developed T-cells from working properly. But by the time we reach this hurdle, it should be easier to develop the necessary T-cells for those people as required.

Just a thought.

### Poor Vivo (1)

#### syousef (465911) | more than 5 years ago | (#26721187)

'We will see if it is safe and if those cells inhibit HIV replication in vivo,'

Alas, poor Vivo. I knew him, Horatio.

first gnaa

### bravo (4, Insightful)

#### Ritz_Just_Ritz (883997) | more than 5 years ago | (#26721225)

While strides have been made in HIV treatment, it's still a death sentence. Doctors can keep the patient alive longer, but they can't prevent the inevitable.

With so many people in the developing world suffering from HIV, it would be nice to see something like this fast tracked. I am sure that some of those folks, now intimately familiar with their own mortality, would be eager to participate knowing that they could potentially help other people.

### Re:bravo (5, Insightful)

#### BlueParrot (965239) | more than 5 years ago | (#26721251)

While strides have been made in HIV treatment, it's still a death sentence. Doctors can keep the patient alive longer, but they can't prevent the inevitable.

Life itself is a death sentence. We all die sooner or latter, it's merely a matter of how long it takes and many HIV positive patients die from unrelated causes ( such as car accidents ). If you catch HIV when you're 70 there's a good chance you will die from some completely unrelated condition, such as stroke, heart failure, or lung cancer from a lifetime of tobacco abuse. Not saying an HIV infection is to be taken lightly, but believe it or not, it is far from the worst diagnosis you can get.

### Re:bravo (1)

#### MichaelSmith (789609) | more than 5 years ago | (#26721427)

Life itself is a death sentence.

Possibly not if we get the ability to directly edit our genes.

### Re:bravo (1)

#### deathguppie (768263) | more than 5 years ago | (#26721513)

Yes indeed my observant friend, death is in fact also a disease. I say death to death!!!

### Re:bravo (1, Insightful)

#### Anonymous Coward | more than 5 years ago | (#26721691)

That is not dead which can eternal lie.
And with strange aeons even death may die.

### Re:bravo (1)

#### GradiusCVK (1017360) | more than 5 years ago | (#26721589)

it is far from the worst diagnosis you can get

Well of course... I would assume the worst diagnosis you could get would be somewhere along the lines of "He's dead, Jim".

### Re:bravo (-1, Troll)

#### Anonymous Coward | more than 5 years ago | (#26721279)

Since that time, with proper adherence to medications, people are now able to live their full lives... meaning, something ELSE kills them before HIV related complications do. While the number of HIV infections increase, the number of full blown AIDS cases and AIDS related deaths have actually DECREASED.

### Re:bravo (2, Interesting)

#### MoellerPlesset2 (1419023) | more than 5 years ago | (#26721347)

With so many people in the developing world suffering from HIV, it would be nice to see something like this fast tracked.

I doubt they view this as a 'cure'. It's research, in both gene therapy and HIV.
If it works, I'd assume the next step would be to try to develop a procedure where they did this to bone marrow cells - the cells that produce T-cells - and thus let the body create its own HIV-resistant T-cells. That might work well enough to be a 'cure' - an HIV patient with leukemia was given an HIV-resistant (CCR5) bone-marrow transplant, and is now effectively 'cured'.
(Though they're careful with the word since HIV virus may still be lurking in the body somewhere)

### Re:bravo (5, Informative)

#### Anonymous Coward | more than 5 years ago | (#26721421)

Actually, this is far from the truth. I am an HIV-positive individual and based on the fact that my HIV was detected early and also that I started on HIV medications within the first year of contracting it my lifespan has been extended to the point where I will most likely live a full life. Before contracting HIV I thought it was a terrible thing to have and that I would kill myself if I ever got it. I have news for you: it is a terrible thing, but just like everything else in the world you get over it and with HIV medications having nearly NO side effects and once-to-twice daily dosing it makes life worth living.

While some may speculate on whether or not I really know what I'm talking about, I do. I am a healthcare professional. For those of you who are wondering why I didn't post this under my account, I would rather not taint Google's results with gossip for my next employer. :)

### Re:bravo (4, Insightful)

#### The FNP (1177715) | more than 5 years ago | (#26721975)

Actually, I figure this is exactly why /. has ACs. We put up with nearly every other AC troll post so that occasionally we can read 'Confessions of a HIV+ Slashdotter'. I don't need to know your identity to read your anecdote. Also, I respect your right to privacy and AC posting more in this case than if you were merely stating a preference for Windows over Linux.

### Re:bravo (0)

#### Anonymous Coward | more than 5 years ago | (#26721455)

While strives have been made in conception, its still a death sentence. Modern science can keep you alive longer, but they can't prevent the inevitable.

### M-x genotype-mode (5, Funny)

#### Anonymous Coward | more than 5 years ago | (#26721231)

You *know* there's going to be an Emacs mode for gene editing.

### Re:M-x genotype-mode (1, Funny)

#### Anonymous Coward | more than 5 years ago | (#26721379)

Screw it, I'll just use Genepad.

### Gene editing? (1, Redundant)

#### TFer_Atvar (857303) | more than 5 years ago | (#26721247)

I'm (pretty) sure it's not like it sounds, but the idea of gene editing immediately conjures up something like a gene Wikipedia in 50 years or something, and that's terrifying and hilarious at the same time.

### Re:Gene editing? (1)

#### 77Punker (673758) | more than 5 years ago | (#26721685)

or gene vim vs. emacs

### Re:Gene editing? (2, Funny)

#### Rayban (13436) | more than 5 years ago | (#26721879)

I think of my accidental select-all, delete-key combos:

"Oh shit... undo, undo!"

### Potential Failure RIsks: (5, Informative)

#### LonghornXtreme (954562) | more than 5 years ago | (#26721341)

There are 3 big risks / problems I see with this approach:

#1: The modified T-Cells attack the host after they are reintroduced. Think of it like auto-immune disease or transplanted-organ rejection. This could cause effects ranging from a mild food allergy to death. Anyone know how much damage 10 billion rogue T-cells could do? I sure don't; however, I do know that they aren't a straight 1 T-Cell used up for each 1 antigen.

#2: Unmodified T-cells attack the modified T-Cells because the surface of the modified T-Cells (i.e. the CCR5 protein) could possibly trigger an immune response. This would render the modified T-Cells kind of pointless. Seems like this would have better chance of working on patients with full blown AIDS rather than merely HIV+.

3: Modified T-Cells survive and are unaffected by HIV; however, these surviving modified T-Cells are just clones of the one original T-Cell that the lab modified. So in essence, you have injected the test subject with 10 billion of the same T-Cell. Unless the doctors have a way of massaging the genes on a representative sample of T-Cells, then this is kind of useless to the patient. What good are 10 billion T-Cells if they are each only good for tagging one antigen? Meaning, that the 10 billion T cells could only respond to a single stimulus, i.e. they could all only fight one strain of the common cold, but not anything else.

Disclaimer: I have a BA in bio from a public ivy; however, my GPA wasn't that great, and I didn't pursue a career in the field. I very well could be overlooking something substantial in immunology etc.

### Re:Potential Failure RIsks: (2, Informative)

#### 10101001 10101001 (732688) | more than 5 years ago | (#26721475)

It sounds like what they're thinking of doing is more like: (1) draw up 10 billion T-Cells, (2) use an enzyme to cleave off the CCR5 proteins, (3) filter out the enzyme+proteins, and (4) reinject the T-Cells. Ie, I don't think issue 3 would crop up (or, at least, it'd be much more limited in scope). The real issue, as I see it, is that those 10 billion T-Cells will eventually die. Not knowing enough about how proteins on the cell membrane are created/carried over during mitosis, it'd seem the biggest issue is that those 10 billion T-Cells are likely to either duplicate and regenerate the CCR5 protein or simply die out before the HIV is eliminated. Either situation would seem to only delay the spreading of HIV in the body.

On the other hand, if it happens that the CCR5 protein isn't regenerated, then perhaps HIV would be cured, but you'd be at risk of redevelopment a random assortment of childhood illnesses (which should just mean revaccination). Unfortunately, I don't know nearly enough about T-Cell reproduction and HIV to know exactly how it is HIV manages to permanently kill off T-Cell production.

### Re:Potential Failure RIsks: (1)

#### LonghornXtreme (954562) | more than 5 years ago | (#26721505)

Thanks for the clarification.

In response to T-Cell production, the HIV article on wikipedia states, "HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4+ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4+ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections."

### Re:Potential Failure RIsks: (1)

#### timmarhy (659436) | more than 5 years ago | (#26721629)

i think the purpose of the test is to see if situation 1 and 2 happen, and to see if the extra t-cells help maintain the patients t-cell count since hiv can't kill them. obviously the next step is to see if they can get the new host to produce resistant cells and cure them of aids via a bone marrow transplant.

### Re:Potential Failure RIsks: (1)

#### sokoban (142301) | more than 5 years ago | (#26721753)

It sounds like what they're thinking of doing is more like: (1) draw up 10 billion T-Cells, (2) use an enzyme to cleave off the CCR5 proteins, (3) filter out the enzyme+proteins, and (4) reinject the T-Cells.

Proteins aren't cleaved, a zinc finger nuclease is used to mutate the CCR5 gene so that it is the HIV resistant type. These are then cloned.

### Re:Potential Failure RIsks: (0, Redundant)

#### caitsith01 (606117) | more than 5 years ago | (#26721731)

Tyrell: The facts of life: To make an alteration in the evolvement of an organic life system is fatal. A coding sequence cannot be revised once its been established.

Roy: Why not?

Tyrell: Because by the second day of incubation, any cells that have undergone reversion mutations give rise to revertant colonies like rats leaving a sinking ship; then the ship sinks.

Tyrell: We've already tried it. Ethyl methane sulfonate is an alkylating agent and a potent mutagen. It created a virus so lethal the subject was dead before he left the table.

Roy: Then a repressor protein that blocks the operating cells.

Tyrell: Wouldn't obstruct replication, but it does give rise to an error in replication so that the newly formed DNA strand carries a mutation and you've got a virus again. But this - all of this is academic. You were made as well as we could make you.

Roy: But not to last.

### Re:Potential Failure RIsks: (1)

#### XMode (252740) | more than 5 years ago | (#26721741)

You forgot the worst one of them all.

4: Zombies

### Re:Potential Failure RIsks: (2, Informative)

#### sokoban (142301) | more than 5 years ago | (#26721743)

I don't think 1 will be a problem. All T Cells have a CCR5 membrane protein, but the HIV resistant ones have a mutant type CCR5 protein. CCR5 is the way in which T cells get infected by HIV, and people with mutant type CCR5 genes survive quite well.

2 may be a problem, and I think will be the biggest hurdle here.

3 Shouldn't be a problem. Zinc Finger nucleases are able to delete the genes from a bunch of different cells at once. The idea is that you get a whole lot of T-Cells, Remove the 32 base pair segment from the two copies of the CCR5 gene in each T-Cell using zinc finger nucleases to make them the HIV resistant mutant type, culture more T-Cells which should be HIV resistant since they have the mutant gene, and inject the T-cells back into the patient.

#### Michael Woodhams (112247) | more than 5 years ago | (#26721407)

Alas, I have enough biology to have questions not answered in the short article, but not enough to extract the answers from the referenced paper. (I did notice that the news article was slightly incorrect on one point. They are not actually 'clipping out' the CCR5 gene. They cause a break in the gene which gets imperfectly repaired, so that the gene becomes nonfunctional.)

Are these T cells capable of 'reproducing' and having an unlimited number of descendants? This is not the case for many types of cells - it is part of what makes stem cells special. The paper refers to T4 cell lines, which suggests that they can indefinitely reproduce.

If the treatment works, how long will it last? (If the answer to the previous question is 'no', the answer to this one will likely be be 'about as long as the lifetime of a T cell.' If the answer to the previous question is 'yes', the answer might be 'for a lifetime.'

Do the modified T cells have to come from the patient? If not, the treatment will be much cheaper: Do the extraction and genetic modification once, breed up a big batch, treat dozens of patients. If not, you need to do the genetic modification once for each patient.

Once you have a bunch of immune T cells, will they be able to eliminate HIV from the body? (I suspect not: I understand that as a retrovirus, HIV is very good at hiding dormant for a long while.)

The answers to these questions are the difference between this being a laboratory curiosity and this being the elimination of HIV in developed countries within 5 years.

#### MoellerPlesset2 (1419023) | more than 5 years ago | (#26721491)

Not that I'm an immunologist, but:

Are these T cells capable of 'reproducing' and having an unlimited number of descendants?

T cells are produced by the bone marrow. They don't reproduce on their own.

If the treatment works, how long will it last?

The lifespan of an average T cell is on the order of 10-20 weeks. I believe. Shorter in HIV patients.

Do the modified T cells have to come from the patient?

Who knows? But not necessarily. After all, you get plenty of foreign T-cells with a blood transfusion. But I don't think anyone is necessarily viewing this treatment as a 'cure' in itself.

Once you have a bunch of immune T cells, will they be able to eliminate HIV from the body?

That's not known. But they've done it [telegraph.co.uk] , with positive effects. Note how 'cure' is put in quotes, as it should be.

The answers to these questions are the difference between this being a laboratory curiosity and this being the elimination of HIV in developed countries within 5 years.

That is ridiculous. It's neither.

### Mutations (2, Insightful)

#### Spooon69 (758526) | more than 5 years ago | (#26721487)

The HIV virus has a high rate of mutation, one of the reasons it sticks around in your body and your immune system has to keep attacking it, it's pretty much a "new" virus every time. What's to keep the virus from mutating and avoiding the CCR5 requirement it currently has? CCR5 doesn't seem to be a requirement for a normal human immune system (one of the many types of backups the immune system has), thus some percentage of the population being perfectly healthy without that receptor. I'd even go as far as to say that if HIV mutates into not requiring CCR5, then this new strain could spread and theoretically be worse than the current HIV strain in the wild.

### The problem... (1)

#### orkybash (1013349) | more than 5 years ago | (#26721529)

Is that HIV mutates *very* rapidly. This is why patients on HIV drugs (AZT and the like) need to constantly change treatments and sometimes take medication vacations - otherwise they get a drug-resistant strain.

That's not to make light of this discovery. It will definitely improve the quality of life for a few patients for a while, and that is a very good thing. Is it a cure for AIDS? Only time will tell.

### Re:The problem... (1)

#### MichaelSmith (789609) | more than 5 years ago | (#26721651)

Is that HIV mutates *very* rapidly.

I wonder if anybody has worked out how many permutations there are.

### two words: brazil nuts (1)

#### tallvegdude (750761) | more than 5 years ago | (#26721571)

There is an argument that AIDS can be thought of as a symptom of severe selenium deficiency that has been triggered by the HIV virus. A recently retired geography prof, Harry Foster, has been doing some interesting work on the subject (his website is at www.hdfoster.com). The summary is: a few brazil nuts a day is a good thing for your immune system, if you aren't allergic to them.

I've always tended to get really nasty colds, a couple a year. Since I started chowing down on the brazil nuts 10 months ago, I've been pretty much free of them. Just don't eat too many (two a day is safe), or you risk selenium poisoning.

### Not to dampen hopes, but... (5, Insightful)

#### wickerprints (1094741) | more than 5 years ago | (#26721771)

Instead of just making the typical /. armchair commentary about the zillion ways in which this proposal would be foolish or at best useless, I'm going to give a different angle on this.

First, on a global scale, the most sophisticated HIV treatments are administered to the relatively wealthy. Only when such a treatment is deemed effective does it start to spread down to the poor, due to economics. The old anti-retrovirals of yesterday are today's low-cost options for the millions of HIV+ individuals in developing nations. That's just the reality of the technological development of disease treatment. However, this "trickle-down" mechanism, combined with natural geographic and genetic variations, has led to the evolutionary branching of HIV into significantly distinct strains, with characteristically different disease modalities.

Second, we have as yet no drug that is able to eliminate HIV in the body. The currently available treatments are at best able to turn HIV into a chronic, managed condition. This has some very interesting (some would say alarming) socioeconomic implications. What we are finding is that over time, HAART therapy has evolved from a multiple-dose-per-day regimen that was difficult to maintain, to a more easily managed schedule, leading to better therapy adherence in patients. However, some of these drugs are poorly tolerated in many individuals, and over time, HIV is known to develop multiple resistances due to poor adherence or tolerance. The more disturbing situation, however, is that in many gay communities, the practice of "pre-exposure prophylaxis" has become alarmingly common. What is happening is that some HIV- gay men are obtaining anti-HIV drugs and taking them prior to knowingly exposing themselves to potentially HIV+ individuals through unprotected sex.

From a scientific standpoint, it is fascinating that this development is as successful as it has been. But from the standpoint of a gay man who takes every precaution to educate myself and follow safer sex practices and does everything in my power to serve as a role model for responsible behavior, I find it totally abhorrent that there are guys who expose themselves willingly to HIV in such an unethical manner, in light of all the AIDS deaths that have come before us and all the tireless work of our most brilliant scientists, medical care providers, and public health advocates. They have even given this "PrEP" cute names and euphemisms to disguise the utter insanity of what they are really doing (like they have done with the term "barebacking" to refer to unprotected anal intercourse). If there is anyone on the face of this earth that deserves to die of this terrible disease, it is them. And I don't say that lightly. Some of you might say that these people would have had unprotected sex with or without the drugs, but you have to realize that it is partly through the action of these individuals that drug-resistant HIV is spread. It is for this reason I dare stand in judgment against them.

So this brings me to my third point. The CCR5 discovery is notable in that it confers strong resistance against HIV-1. Two copies of the gene are required for this resistance. However, the transmission of other strains of HIV may not be blocked by the presence of this gene. Even if this therapy were to work, I doubt it would be effective on a large scale. Some of these patients, if you cure them, will simply go out and have more unprotected sex. If you don't believe me, reread the previous paragraph.

The only way human civilization will ever rid itself of the scourge of HIV is if we discover a vaccine or outright cure for all its strains. No chronic management or piecemeal therapy will be sufficient, because there are always people who will do things that will enable the virus to mutate and survive. Ever since the discovery and announcement of the virus in the 80s, this simple fact was apparent to me. But the untold billions of dollars in revenue that HIV research and management brings to certain groups has also led them away from this truth. HIV disease management and treatment is a double-edged sword. The very same efforts used to combat the disease are also the very same evolutionary pressures that cause the virus to mutate and prolong its global virulence. Twenty years on, I believe that if no treatment were ever developed, we would have lost many, many more lives, but people would have been a lot more careful--and as a result, we may actually have had fewer infected individuals today. Instead, we now have communities who not only rely on the existence of these life-prolonging drugs, but in fact exploit them for purely selfish reasons.

The problem of HIV is not medical or technological in nature. It is a social, cultural, and economic problem.

### Herpes? (0)

#### Anonymous Coward | more than 5 years ago | (#26721775)

Now if only they could have this therapy cure herpes patients.

### Cost? (1)

#### failedlogic (627314) | more than 5 years ago | (#26721787)

I don't mean to be a pessimist, but it seems that this will, if approved, be a lengthy and costly procedure.

I'm unaware of the types of legal wrangling for a doctor and a hospital before a procedure is taken. I'm also unaware if there are any ethics reviews done prior to risky operations/treatments (brian, heart, gene therapy). Given at least the legal risks, unless there's a 99.999% success rate, I'm not sure doctors or hospitals will want the procedure in-use (even if the person is likely to die of HIV/AIDS anyways).

Since there's also process patents, I'm concerned a Pharmaceutical might buy the 'rights' to the procedure. If said Pharma already sells HIV/AIDS drugs, the price for this procedure will be very costly. I'm not sure some celebrity victims would be able to afford it.

I'm just hopeful that this is a path to the magic-bullet. This is a devastating virus that has afflicted many countries and urban populations.

### will this select for more virulent HIV in CCR5null (1)

#### OGmofo (189475) | more than 5 years ago | (#26721789)

So these HIV patients will simultaneously be hosting HIV in CCR5wt cells providing a steady stream mutant HIV particles to try their luck at cracking CCR5null T cells.

Hopefully CCR5null is a real deal breaker for HIV or we might be creating the perfect situation for HIV to maximize its chances of overcoming that hurdle.

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