A cure for HIV? Feasible but not yet realized

Faith Castro
March 10, 2019

At the conference in Seattle, scientists said the London patient had been free of HIV for 18 months without taking antiretroviral drugs.

The first such case of an HIV patient being cleared of the virus after a bone marrow transplant happened a decade ago to Timothy Brown, known as the "Berlin patient", who is still free of the virus. In Europe, this change is present in about 1% of the population, meaning that these individuals are much harder to infect with HIV.

Top panel illustrates the treatment course for the London patient.

Experts universally hailed the case, even as they cautioned that the procedure that resulted in the likely cure - a bone marrow transplant to treat blood cancer - is too risky and costly to be applied as a general treatment for HIV, which can today easily be managed, though not cured, with pills. In 1997, David Ho of the Aaron Diamond Institute announced that the new crop of anti-retroviral drugs would probably be able to knock out the virus in patients after they continued the regimen for a number of years. He developed cancer and agreed to a stem cell transplant to treat the cancer in 2016. The Berlin patient had his immune cells replaced with ones from a donor with a genetic mutation that disables a receptor called CCR5. Brown has previously spoken of how he counts the date of the first stem cell treatment-February 6, 2007-as a new birthdate of sorts, because it was on this day that, unbeknownst to his doctors at the time, he would apparently be cured of HIV.

You may have noticed that I have repeatedly referred to this treatment as an "apparent cure" and more frequently HIV remission, and this is for a good reason.

3rd patient reportedly cured of HIV in incredible medical breakthrough

Another man appears to have achieved remission from HIV, but what does this mean, and does it indicate that we are closer to a true cure for the virus? People with HIV are sometimes more susceptible to the development of cancers, but only a minority of people living with HIV have cancer.

Another patient who had this treatment was later found to be infected with a form of HIV called X4, which uses a different receptor to enter cells. Additional follow-up research must be done to insure that the new bone marrow produced reconstitutes the patient's immune system with the CCR5 genetic mutation so that HIV treatment can be stopped.

The London patient is one of 38 patients given bone marrow treatment, including six who used donors without the mutation, that a group of researchers is following. Instead of having to keep in mind to take pills, patients instead could get injections from a doctor or nurse each month.

Co-organised by Vietnam Authority for HIV/AIDS Control (VAAC), Ministry of Health and the US President's Emergency Plan for AIDS Relief (PEPFAR), the events mark an important milestone in securing domestic sustainable financing for the HIV response in Việt Nam and ensuring that people living with HIV access treatment services. Yes, these new drugs hopefully have less side effects to extend the life long use of expensive pharmaceuticals by all people living with HIV, but they are not a cure. The patient must then be monitored to insure that his or her HIV does not come roaring back.

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