Why Bone Marrow Transplant Is Too Risky to Be a Cure for HIV

The goal of human immunodeficiency virus (HIV) eradication has not yet been achieved despite the use of antiretroviral (ARV) drugs. ARVs don’t treat HIV. They keep the viral load under control. They lower the level of HIV in the blood so that it cannot damage the immune system. When an HIV patient takes these drugs, the viral load in the bloodstream goes down. When the viral load goes down, the rate of white blood cell damage goes down too. The main problem with antiretroviral treatment for HIV is that you have to keep taking the drugs. Once you stop taking ARVs, the viral load in your body will go up and increase the rate of white blood cell damage. Increased white blood cell damage lowers the immune system and makes you more vulnerable to diseases. In this article, you will find out why doctors don’t recommend bone marrow transplant to treat HIV 

Bone Marrow Transplant for HIV Treatment

Researchers have been looking for a better treatment option for HIV. A bone marrow transplant can cure HIV, but the risks are not worth it. It is only preferred when a person’s marrow is not healthy. 

Bone marrow issues might be due to a chronic disease, infection, or cancer treatment. These conditions affect your body’s ability to produce new healthy blood cells. Bone marrow cancer is the most aggressive.

These diseases and their treatment can cause life-threatening complications. 

Bone marrow transplant is the most effective treatment for diseases like leukemia, sickle cell, and lymphoma. Some leukemia patients that were HIV positive achieved HIV remission after undergoing a bone marrow transplant. To achieve HIV remission, a patient needs to get a customized bone marrow transplant from an HIV-resistant donor.  

Several patients have successfully achieved HIV remission after bone marrow transplant during cancer treatment. The first person was the Berlin patient who received not less than two bone marrow transplants to treat acute myeloid leukemia. The bone marrow was from a person with HIV resistance mutation. The patient was declared HIV free some months after the treatment. 

The second patient had Hodgkin’s lymphoma. Researchers took advantage of his cancer treatment to tackle his HIV infection. They transplanted the patient with bone marrow from a person with a genetic mutation giving him resistance to HIV infection. Doctors paused his antiretroviral therapy 16 months after the surgery, and according to Nature Magazine, the patient was still HIV free 18 months later.

Why Doctors Are Against Bone Marrow Transplant for HIV Treatment

Many doctors don’t recommend bone marrow transplants for HIV treatment. That is because bone marrow transplant is an invasive procedure. It has a high morbidity and mortality rate than HIV itself. Bone transplant is only safe for patients with severe leukemia or any other type of refractory blood cancer that does not respond to other treatment options.

Doing a bone marrow transplant for all HIV positive patients is likely to kill more patients than HIV itself would. Performing a bone marrow transplant to treat HIV is like cutting off your legs to treat knee pain. It will cause more harm than good. 

Finding a matching donor that is carrying a mutation that makes him or her naturally immune to HIV is another nightmare. On average, there is only one bone marrow donor with a perfect match for you in a group of 30,000 to 60,000 randomly chosen people. The mutation that will give you immunity to HIV occurs at about one percent of the entire population. That means you will need to collect health data for three to six million donors to find a perfect match for one HIV positive person. 

Data collection is not a big problem now that we are in the digital era. If the United States of America, the European Union, the United Kingdom, Canada, South Korea, Japan, and a few others pool their resources together, data collection can’t be an issue. An allogenic bone marrow transplant has a death toll of approximately 20 percent, and that is why it is not safe for HIV treatment. The treatment might kill more people than HIV itself.

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