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By Rishi
A condition called Graft Versus Host Disease (GVHD) was foud among some immune deficient persons, who received bone marrow transplants. Later this condition came to light among certain patients, who were immune incompetent and who were transfused with blood products, which had immune competent cells. GVHD is not very common. But when it does happen it is often fatal. There seems to be no cure for this. Only prevention. Prevention is by using irradiated blood products.

Haemo-dialysis is a common procedure for alleviating kidney malfunction. The affected person's blood is pumped out, filtered, and put back into the patient online.

The virus causing HIV is not very hardy and is easily deactivated once it is outside the person.

The idea being proposed now combines the above three factors. Put an AIDS person on a dialysis type of machine, deactivate HIV by irradiating his/her blood to the currently practised doses of Gamma Irradiation, and put it back into the patient. Monitor the progression of AIDS and repeat the procedure.

At the least this may arrrest the progression of AIDS, and significantly improve the quality of life. At best it may effect a complete cure.

An adult has about a gallon and half of blood. With the blood irradiators currently available it should be possible to irradiate this quanity of blood to the prescribed dose of Gamma Rays in about half an hour. Since blood circulates through every nook and corner of the body, HIV lurking anywhere should get flushed into blood. The procedure is painless and can be repeated as often as haemo-dialysis, which is often done thrice a week.

The irradiator is rather expensive. But the running costs are negligible. The procedure does not conflict with any ongoing Anti Retroviral Treatment. Many can be treated in a day.

There is nothing out of the way in the proposal. All the procedures and equipment are known, available, and in routine use. The only new thing is the suggested application.

Unfortunately there does not seem to be a suitable animal model for trials. The trials probably have to be done on humans only. There is one soft option. Initially blood can be drawn from an AIDS patient and irradiated offline. Deactivation of HIV can be checked. If enough data points to this primary objective being met, the irradiated blood could be transfused to the same patient and monitored for any adverse reaction. If this also passes then a full scale online trial as suggested above can be done.

Reward: It is a crime to expect to be rewarded in this kind of case.
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By Agnes_Ng
I am very interested in finding the way to cure AIDS. I have always thought about ideas and would one day really like to test them. One of it was almost a bit similar to yours, though not as clear as yours.I was wondering have you ever tested it? If you have, can you please tell me the results?.

by the way, I thought your idea is good. ;-D
By Rishi
I have worked a lot with developing devices for blood banking. We are trying to set up a blood irradiator in one of our blood banks for GVHD.

I have also done considerable work on gamma irradiation for other purposes like sterilization of medical devices. Unfortunately, I have not yet had a chance to test this out because it needs a multi-disciplinary effort with haematologists, virologists, and Aids workers.

If it works, it may alleviate a lot of suffering. So I posted this idea incase someone else is interested.

Your concern is reassuring. I shall of course keep posting any developments in this area that I come across.

By midoh
Rishi, I think this idea has got real potential.I can see how the difficulties in organising multidisciplinary teams may slow things down a bit. The gamma ray source and Haemo-dialysis immediatley make one think of a large well equipped hospital with Nuclear Medicine and other complex facilities. I think the first challenge is going to be getting the treatment up and running in these areas .The next is somehow to make this treatment available to people in more remote areas(in some sort of field hospital set-up say ). The reason I say this is because most of the worlds' aids sufferers are located in Africa. The complex facilites required initially for the treatment will only be available in the major cities .
I wish you good luck and every sucess in your endeavours! ;-D
By Rishi
Dear midoh,
Thanks for the encouragement. It was probably an India centric posting in that a significant portion of HIV+ people turn up in big towns with good facilities.
What you say makes sense.
The first part of the trials, which is to check if at all the idea works, can be done in any city with a gamma irradiator for blood. Blood from any HIV+ person can be collected in the usual manner by any blood bank. They may already have a few units by the time the tests of existing donated blood is complete. These can be irradiated in the GVHD irradiator and tested for viral inactivation. If the process proves effective, even the second phase, that is, putting this blood back into the HIV+ donor can be done off-line.

Only if this also proves satisfactory, the issue of on-line treatment arises. With the huge threat of mushrooming AIDS and the cost to the whole world related to AIDS (Direct costs and human suffering) I hope funds will be fothcoming to set up these facilities anywhere.

The capital cost of all equipment neede works out o about 200,000 Euros. Most of these can be operated by trained paramedics. About 40 patients/week can be treated assuming three visits /week/patient.

Since we expect a complete cure in about 10 visits, we can expect to handle 200 patients a year, which is not an alarming cost, considering that there is very little consumable cost. If fully worked out it may turn out to be about 250 euro/patient.

Thanks once again. Let us see if ny hospital/Blood Bank will take up Phase 1 and 2. You will be kept informed.

By Rishi
Dear midoh,
after your last post I was encouraged to try to push this through and took it up with one the seniormost medical professional, who has a say in policy issues at the highest level in the country. His reply is very positive. It seems possible that the project may get taken up by a multi-disciplinary team.

If it does get going it will be a nice thing that something that started on this site gets a proper R&D study.

It is exciting and worth watching.+
By Rishi
Dear midoh,
after your last post I was encouraged to try to push this through and took it up with one the seniormost medical professional, who has a say in policy issues at the highest level in the country. His reply is very positive. It seems possible that the project may get taken up by a multi-disciplinary team.

If it does get going it will be a nice thing that something that started on this site gets a proper R&D study.

It is exciting and worth watching.

By hugo
Haemo-dialysis seems to be a potencial way to deal with HIV so many people must have tought of it before (I had).

The interesting part is gamma irradiation and you experience with it. The problem is: does it destroy HIV on the blood stream and those inside the white cells?

There should be plenty information on it, try to make a seach
Effects of gamma irradiation on the human immunodeficiency virus. A study in frozen human bone-patellar ligament-bone grafts obtained from infected cadavera.

Fideler BM, Vangsness CT Jr, Moore T, Li Z, Rasheed S.

Department of Orthopaedic Surgery, University of Southern California School of Medicine, Los Angeles 90033.

We studied the effects of several different doses of gamma radiation, ranging from 20,000 to 40,000 gray (2.0 to 4.0 megarad), with respect to the inactivation of the human immunodeficiency virus in fresh-frozen, whole bone-patellar ligament-bone grafts. Although the International Atomic Energy Agency has recommended the use of 25,000 gray of gamma radiation for the sterilization of medical products, the dose required for the inactivation of the human immunodeficiency virus in frozen allografts has not been established. Using one of the most sensitive and specific tests for the detection of the human immunodeficiency virus, the polymerase-chain-reaction test, we found that doses of 20,000 or 25,000 gray of gamma radiation did not destroy the genes of the human immunodeficiency virus effectively; DNA of the virus was detectable in the DNA of bone-marrow tissue obtained from grafts treated with these doses. However, DNA of the human immunodeficiency virus was not detectable in the grafts treated with 30,000 or 40,000 gray of gamma radiation. We conclude that a dose of 30,000 gray of gamma radiation or more is necessary for the sterilization of a fresh-frozen bone-patellar ligament-bone allograft, so that it can be used for reconstructive procedures without the risk of transmission of the virus to the recipient.
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