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For AIDS, 'Cure' Is Still a Four-Letter Word

November 13, 2008 4:23 PM

By Dan Childs, ABC News Medical Unit

It’s a line that I must have heard in no fewer than a dozen journalism classes -- probably something having to do with headline writing or news placement:

“… So say, for example, that they invent a cure for AIDS.”

For the professor, the idea was to come up with a hypothetical situation that was so earth-shattering that it could be used to illustrate a teaching point -- and at the same time so unlikely and fantastic that we students would not get distracted by pondering the likelihood of whether such a thing could actually come to pass.

The teaching point is this: There are some stories that, when they break, must be given prime placement. They must be shouted to the world.

So when the news rolled across the wires that German doctors report removing all traces of HIV from an American man’s body, perhaps it was little surprise that these headlines followed close behind:

-- AIDS Cured Via Bone Marrow Transplant
-- Patient Gets Accidental AIDS Cure
-- AIDS Cure Found
-- Bone Marrow Transplant Cures Man of HIV Virus
-- German Doc Miraculously Cures AIDS Patient

The list goes on. The reports that carry these headlines come from around the world, from New Zealand to Massachusetts.

But what they all have in common is medical journalism’s most infamous four-letter word -- cure.

Is it a problem in this case? Let’s take a look at the facts. The patient is a 42-year-old man who had been HIV positive for the past decade. He also had leukemia.

Doctors at the Berlin Charite hospital’s Clinic for Gastroenterology, Infections and Rheumatology hoped to treat the man’s leukemia through a bone marrow transplant, in which the patient’s entire immune system is killed off and replaced through an infusion of bone marrow from a donor. In this case, the doctors found a bone marrow donor who also had a rare genetic mutation that made the donor resistant to HIV infection. The procedure got rid of the leukemia. But doctors were also startled to find as well that no traces of HIV remained in the man’s system.

If you are a big fan of happy endings, feel free to stop reading this blog here. Heck, you can call this episode a medical miracle and feel delighted for the unnamed patient, who’s most likely on cloud nine himself at this point.

For those of you who want to stick around, here’s the other side of the coin.

Attempts to treat AIDS using bone marrow transplants are not new; in fact, they have been tried many times -- as early as 1982 and as recently as last year -- usually with little success.

Today, there are perhaps three or so cases in which a bone marrow transplant appears to have sent the disease into remission -- which means that either: 1) The virus is completely gone; or 2) It is still present, but in levels too low to be detected by current means. The safer bet is the latter.

Why might this be? And what happened to the several dozen others who got new bone marrow, but died anyway?

For one thing, AIDS researchers say the changes that the virus makes to the DNA once it’s in the body are not wiped out with the immune system. Thus, when the immune system “reboots,” the HIV signature remains and the whole infection process restarts.

The other thing to remember is that, today, millions of people infected with HIV are on a steady cocktail of anti-retroviral drugs that keep the virus at bay. In many of these people, levels of the virus are also undetectable. Provided they keep taking their medicine, many can remain alive in this state for decades. Does this mean that they are “cured”? Far from it. Take the drugs away, and HIV will emerge from its reservoirs in the body and begin its rampage on the immune system once more.

On our site, we ran the Associated Press story with the headline: “Cure for AIDS, or Lucky Fluke?” The answer, of course, was implicit. But perhaps it would have been better if we had left that infamous four-letter word out altogether.

Cases like this most recent one in Berlin give us real hope for new directions in treatment. But if hope for a cure, when teased apart, is found to be false, it can have an undermining effect on positive findings. For a disease for which good news is already in short supply, some hope can easily turn into no hope, and we find ourselves faced once again with the specter of a horrific and seemingly invincible disease.

Sure, call us skeptical. We’ll continue to man the battlements, looking for the next shred of hope against this killer.

Meanwhile, journalism professors the world over can rest assured that the sanctity of their hypothetical headline remains intact, for now.

November 13, 2008 | Permalink | User Comments (9)