BERLIN—In the first case of its kind, a U.S. citizen living in Berlin has been cured of HIV, according to the doctors who treated him. While the treatment was grueling and not yet scalable, and a general cure for the virus will take more funding and research, the news that Timothy Ray Brown, who had developed acute myeloid leukemia, has been pronounced cured of HIV after undergoing a stem cell transplant represents a very real ray of hope for millions of people around the world.
The stem cell treatment that led to the eradication of the virus was conducted in 2007, according to aidsmap.com.
“The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells,” reported the site. “The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.”
First published in the New England Journal of Medicine in February 2009, the results of the treatment were first reported in 2008 at a conference on retroviruses and opportunistic infections in Boston. The doctors—Kristina Allers, Gero Hütter, Jörg Hofmann, Christoph Loddenkemper, Kathrin Rieger, Eckhard Thiel and Thomas Schneider—submitted a follow-up report this September to the journal Blood, which it accepted in December.
“During the process of immune reconstitution, we found evidencefor the replacement of long-lived host tissue cells with donor-derivedcells indicating that the size of the viral reservoir has beenreduced over time,” the doctors wrote. “In conclusion, our results strongly suggestthat cure of HIV has been achieved in this patient.”
In an interview with German magazine Stern this week, Brown said he suffered two relapses and underwent two stem cell transplants during his treatment, as well as a “serious neurological disorder that flared up when he seemed to be on the road to recovery.”
He is feeling better, however, enjoys a drink and cigarette even, and is contemplating a move from Berlin to either Barcelona or San Francisco.
Considering the length and grueling nature of his treatment, when asked if he thinks it might have been better to live with the virus rather than undergo the treatment, he said, “Perhaps. Perhaps it would have been better, but I don’t ask those sorts of questions anymore.”
Looking to the future, aidsmap.com reports, “Scientists were sufficiently intrigued by the Berlin patient that they met in Berlin in 2009 to discuss how they could coordinate efforts to identify CCR5-delta32 homozygous donors and expand the supply of stem cells from these donors, for example through sampling blood cells from the umbilical cord of babies born to mothers who are homozygous for CCR5-delta32, in order to eventually facilitate stem-cell therapy.”
In October of 2009, several U.S.-based research groups that they had received funding to explore techniques for engineering and introducing CCR5-deficient stem cells, said the site.
“If these approaches prove successful they will be expensive, so in the early stages it is likely that they would be reserved for people with no remaining treatment options or a cancer requiring bone marrow or stem cell transfer,” wrote Keith Alcorn. “As Timothy Brown’s experience shows, curing HIV infection through ablative chemotherapy, immunosuppressive drugs and stem cell transfer is not a course of treatment for the faint-hearted.”
As with any news heralding a breakthrough in the search for a cure for HIV, not everyone is convinced that Brown has in fact been cured.
“Dr. David J. Ores, a general practitioner on the Lower East Side of Manhattan says that while the thought of a cure for HIV is appealing, he's not sure if this one case is the answer,” reported AOL Health.
"This patient has many unique factors," Ores told AOL Health. "He had leukemia. Twice. He had all sorts of chemotherapy and radiation. Twice. His genetics are unique to himself (like anyone else). The HIV could be dormant for now. We also don't know which sub-type of HIV he had, or if he had other infections in the past which [affect] his immune system."
According to AOL Health, Ores questioned whether Brown even had HIV.
"Maybe his leukemia affected the HIV test since HIV is, in fact, leukemia as well,” he said. “Recall, HIV was originally classified as 'HTLV type one' which stands for Human T-Cell Leukemia Virus (HTLV). So maybe his other leukemia affected the test for the other HIV leukemia (HIV).”