Men “cured” of HIV by bone marrow transplant suffer relapse

Two patients from the US, who were thought to possibly have been cured of HIV, have relapsed.

These two men were both HIV positive and had lymphoma, a type of cancer. They both received bone marrow transplants. Post-transplant they continued on their antiretroviral medicine (used to combat HIV) while the donor bone marrow cells engrafted. Researchers found that all traces of HIV in the patients vanished.

They were followed and, in time, both patients stopped their antiretrovirals. They remained HIV free – or so everyone thought, since their viral loads were undetectable and no trace of HIV was found in peripheral blood cells.

Men thought “cured” of HIV, relapse

Unfortunately, over time, both relapsed and tests showed HIV was again (still) present.

HIV can lie dormant in some cell types, sometimes for years. Then, for some reason, the dormant HIV in some of these cells reactivates and causes the cells to produce new virus. That’s apparently what happened here. Some HIV infected cells remained and reactivated.  I’d written about this in more detail earlier:

A third impediment to finding a cure is that some virus can enter cells and remain dormant, sometimes for a very long time.

cdrin / Shutterstock.com

AIDS-HIV activist dispenses awareness information near Yoyogi Park, popular with teens and young adults on Sept. 18, 2009 in Tokyo. 20-30 year-olds have the highest rate of HIV in Japan. cdrin / Shutterstock.com

The HIV virus enters cells, transcribes its RNA into DNA, merges with the cell’s native DNA and waits. The virus has safely sequestered itself from the patient’s immune system and the ARV [antiretroviral] medications the patient is taking. It remains there, ready to become active at some future time. HIV can remain there, inactive and hidden, for a long time.  It is estimated that, based on the number of infected cells, the amount of virus present, nature of the ARVs used and other factors a patient would need to stay on ARVs for 70 years before all of the dormant virus activated and was subsequently destroyed.

While the patient remains on antiretroviral therapy the viral load may become undetectable. At times, in some cells, the viral DNA may become active again, even while on ARVs. The renewed activity will cause production of new virus that will be released into the circulation, and cause the death of the cell producing the virus. Once the HIV is free, however, the ARVs can work against it and neutralize it. But take the patient off of antiretroviral medications and, sooner or later, some viral DNA will activate and spread. And with no ARVs being present, more cells become infected and the viral load rises. Thus ARVs are thus not a cure for HIV, by themselves, because they don’t get at all the hidden virus.

Researchers will review this information, and this data may be useful in future research. Some other possible cures (“functional” cures) may have occurred using other methods.

HIV vaccine fraud

More bad news on the fight against HIV/AIDS. A researcher has been implicated in falsifying data in an HIV vaccine research project. Dr. Dong-Pyou Han, an assistant professor at Iowa State University, resigned his position there after an investigation showed that he deliberately falsified the results of experiments.

Han presented data that showed that the vaccine he was working on produced a significant antibody response in rabbits that were given the vaccine. However, over a few years’ time, other researchers were unable to reproduce the results and called his data into question. Apparently, Han added human HIV antibodies to the rabbit samples to make it look like the vaccine was working well and producing an excellent immune response in the rabbits. The rabbit samples were sent to another lab that tested them and found that they had indeed been “spiked” with foreign antibodies.

Upon investigation, Han appeared to be the likely suspect. When confronted, he confessed and submitted his resignation. The National Institutes of Health, which funded the research, will not permit Han to receive further grant funding from them for three years. (More on that wrist-slap in a moment.)

This research appeared promising enough that the NIH doled out almost $20 million dollars over several years to support it. The NIH can demand that the money be returned by ISU, though that rarely happens. Theoretically, the university is responsible for the quality of the research done by its faculty. Obviously, that would be an impossible task for any university. But the fault here seems to lie with only one researcher.

In addition to the fraud he committed, the research produced by Han was misleading. Other researchers may have tried to use his data in their research, and been hampered because it was altered. Not only did Han falsify his research, his actions may have caused delays or failures in others’ research, which cost valuable research dollars in addition to time.

A three-year ban on receiving funding from the NIH doesn’t seem like very much in the way of discipline. Perhaps, in cases like this, we ought to consider prosecuting the perpetrator, to the extent the law allows.  And if it doesn’t allow, perhaps the law should be changed.


Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • Johnny Appleseed

    I am O negative blood type that means I am compatible with all blood types right so I can get the CCR5 gene from any blood type person correct.?

  • Johnny Appleseed

    I have read of a research where they were actually getting the HIV out of the dormant areas of the DNA I think that if the people who were researching this subject got together to share the parts of the virus they were studying that a cure would be possible in a much faster pace than it is.

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  • rickyponting373

    Most likely any upcoming aids cure will more than likely incorporate bone marrow transplantation as being a beginning point, when regarding simply no some other cause than to obtain the viral insert in order to tough in order to discover levels.

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    non YHWH gave the cure–a man only has to die once, to which the second death hath no power, there shall be no more death, genes is 3–what is an Anthrax Vaccine? are any vaccines safe? what is the knowledge of gOOd and evil live? how are vaccines made? what do they do? what are auto immune diseases? what is the ever living gospel?—servants pass on to the next LIFE.yes.j

  • MediaMentions

    It’s a little off topic, but I’ve been reading up on innovative transplants and they have managed to transplant a uterus, which for me is amazing and a step with loads of potential. Here’s the official press: http://www.pressreader.com/bookmark/G4N2CAJ52LR5/TextView. I’d personally like to know if the organ donor’s genetic makeup will be reflected in the child (provided it’s possible to conceive)

  • nhf7170

    Finding a match with the CCR5 gene might be a challenge.

  • docsterx

    I agree that there is a lot of pressure on researchers to produce and publish to get promotions, funding, academic tenure, etc. He doubtless felt it, too. It’s a shame in that he may actually be very good at research. Maybe just this time he decided to “enhance” his results.

    Apparently his rabbits were producing some level of antibodies after he injected them with the vaccine. So, had he not “doctored” his results, he might still have gotten the grants. But this will be another case of the “what ifs.” What if he had been honest? What if other researchers hadn’t gotten sidetracked?

    It’s just a sad story in so many respects – fraud, academic dishonesty, raising false hopes.

  • docsterx

    He also shills for Dr. Agbadi who cures HIV, casts spells for love, cures cancer and “herpatitis” and does other miraculous things. http://dr-agbadi-home-of-solution.webs.com/ The English used sounds very much like those Central Bank of Nigeria scams where the author is willing to share $26 million US with the recipient in exchange for a few fees paid up front.

  • docsterx

    Neither the headline nor the article mentions the Berlin patient.

    You’re right, the Berlin patient got marrow from a donor who had a natural immunity to HIV. These patients did not, But people with that particular genetic make up are rare. And using the methods used on the Berlin patient to treat others would be limited to just a few people. The link to the previous article (above) explains. http://americablog.com/2013/07/hiv-aids-cure-bone-marrow-transplant.html

  • perljammer

    The article you linked to made an interesting point about the pressures to publish and obtain grants. I wonder how far Han got into his research before he realized that it was a choice between stopping and admitting failure, or continuing and committing fraud? Hard to believe he was planning on going to the dark side from the very start.

  • I’m sure any future cure will likely include bone marrow transplantation as a starting point, if for no other reason than to get the viral load to difficult to detect levels. The research now needs to focus on detecting and eliminating the virus from those storage cells where it lies dormant. Since trying to find immune donors in any way other than blind luck isn’t really a viable option for widespread treatment.

  • Agreed. Predators who look for people who could be looking to turn to anyone promising help in a time of desperation are sickening, but those kind of despicable bottom feeders have been around since the dawn of time. Especially on the internet, there’s a pretty easy rule to go by: If what they’re offering sounds too good to be true, it is.

  • Nate

    No, it doesn’t mean that at all. This study didn’t transplant bone marrow from a donor with the CCR5 gene like the Berlin patient got, so of course it’s entirely unsurprising the HIV came back. The ART was what was eradicating the HIV, not the bone marrow transplant. It’s a shame these donees weren’t given the bone marrow from someone immune to the virus, and they would have the mutation now too (as does the Berlin patient, who last I checked is still “cured”.). Bone marrow transplant is still promising but the mechanism is the CCR5 mutation, and *not* the bone marrow transplant in and of itself.

  • Nate

    This headline is deeply misleading!! The famous “Berlin” patient is *not* one of the patients who suffered a relapse, and this doesn’t spell the end of the bone marrow transplant cure at all! Short of it–The true bone marrow transplant cure occurred when the transplanted cells were taken from a donor with a mutation that made the donor immune to HIV. In this instance, it worked. This study took bone marrow from donors *without* the mutation, from persons who are *not* immune to HIV, and then arbitrarily stopped antiretroviral therapy on the donees. Of course the virus came back. What would you expect? The only reason it worked on the Berlin patient is because he inherited a mutation from his donor which made his transplanted immune cells incapable of being infiltrated by the virus. These patients did not. An unsurprising study that does absolutely nothing to discourage the bone marrow cure’s promise.

  • Bill_Perdue

    Bad news.

    No free lunches with retroviruses.

    Thanks for the report.

  • Yeah, I had figured as much. And it’s criminal. Hawking some ineffective crap to people who have a serious health condition is grounds for being drawn and quartered, in my opinion. I’ll be flagging both of his comments now.

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  • Just a spam predator, posting this exact same thing on every blog that even mentions HIV. He’s just looking to dupe some desperate and gullible people out of their money.

  • I am deeply suspicious of your claims. If this reported cure had the claimed results, it would not be an obscure thing that no one has ever heard of and presented as a comment on a blog.

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  • Dammit… the bone marrow transplant seemed so very promising. I guess the virus must have more hiding places in the body.

  • docsterx

    Sadly, this kind of fraud and other cases of data “fudging.” including plagiarism, data theft and other forms of cavalier treatment of research data, seem to be becoming more common. Take a look at Retraction Watch (or similar sites). http://retractionwatch.com/ They publish daily notices of papers being retracted for just such improprieties. Han’s data was peer reviewed, in that others trying to duplicate his results were unable to. That’s what led to the investigation of his research.

    In this case, the researcher (and his colleagues) used $15 million dollars that could have been spent on more valid research. Also, the faked results probably misled other researchers and caused them to waste time and their grant money, as well.

    You’re right that his career is probably finished. But for someone who blatantly tampered with data, defrauded his funding institution, misled his colleagues and embarrassed his university, I’m not sure that just allowing him to vanish into obscurity is enough. And, of course, he had the ego to think that he could do what he did and get away with it.

    Here are a few of the more major perpetrators of scientific falsification (maybe in one case, just carelessness): http://healthland.time.com/2012/01/13/great-science-frauds/slide/scientist-rogues-gallery-2/

  • docsterx

    Here’s an overview with some comments from other researchers: http://www.bostonglobe.com/lifestyle/health-wellness/2013/12/05/hiv-virus-returns-after-cure-hope-rose/kSUyH1YkgJ27AP4aZwpUXJ/story.html

    Interestingly, researchers from Harvard, MIT, Massachusetts General Hospital and other sites may have identified the type of cells that act as a long-term reservoir for HIV. The article was just published a few days ago. http://www.massgeneral.org/about/pressrelease.aspx?id=1664
    The research article is available online at Nature Medicine, but it is behind a paywall.
    http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.3445.html#access

  • perljammer
  • KevinCW

    Can you please share the source report for the relapse?

  • perljammer

    The three-year ban on receiving NIH funding does seem like a slap on the wrist. However, this guy’s career is over. He is extremely unlikely to ever be in a position to solicit a grant, let alone receive one.

    I’m not so sure I would want to see him prosecuted. More than a few researchers have been accused of doctoring (sorry, Mark ;-)) data or otherwise fudging their results, only to be exonerated by peer review; see, for example, the flap over climate change data a while back. Chances are this guy wouldn’t have confessed so readily if he had been facing criminal charges. As it is, he’s been removed from the picture and the community knows his technique isn’t valid.

  • bkmn

    Han committed fraud. Prosecute him and any faculty members that knowingly assisted him.

  • S1AMER

    So sad, so very sad. It looked like scientists might have been on the verse of a breakthrough with the bone-marrow transplants.

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