First man cured of HIV?

Four years after receiving a bone marrow transplant and radiation therapy, a formerly HIV positive American man remains free of the virus and is not taking HIV medications.

On December 2 researchers published a paper in the Journal of the American Society of Hematology arguing that it is “reasonable to conclude that cure of HIV infection has been achieved in this patient”.

Timothy Ray Brown was HIV positive and being treated for leukaemia in Germany in 2007 when his doctor, Gero Hutter, decided to follow up on a hunch.

Although not an AIDS specialist, Hutter was aware that less than 1 percent of Europeans carry a mutation that, when inherited from both parents, gives them a heightened immunity to HIV.

The mutation means that a molecule known as CCR5 does not appear on the surface of their cells. HIV uses the CCR5 molecule to enter healthy cells and infect them.

Hutter consulted with superiors and began the search for a donor with the mutation who was compatible with Brown.

When one was found Brown was given a powerful course of drugs and radiation therapy that killed his bone marrow and many of his immune cells- wiping out active HIV infected cells in his body.

They then transplanted the donor bone marrow which began to produce immune cells with the mutation which spread throughout his body.

Initially doctors asked Brown to stop taking HIV medications so as to not affect the ability of the new marrow to survive, with the intention that he would resume them if the virus reappeared.

But it never did and by November 2008, Brown had been off medication and without detectable HIV in his body for 600 days.

Another thing that researchers says Brown to be HIV free is that HIV can mutate to use a different molecule to enter cells, so any dormant virus should have mutated to exploit this and retaken hold in the body in the meantime if any remained undestroyed.

The procedures Brown underwent required long periods of extreme discomfort and carried a high risk of complications including death, and that coupled with the rarity of compatible donors with the mutation mean it is unlikely to be used with many other patients.

However scientists are hoping the immune effect could be transferred to patients in the future by developing a therapy that alters their genetics to include the mutation.

National Association of People Living With AIDS (NAPWA) Executive Director Jo Watson said she had been closely following the so-called “Berlin Patient” case from when the first results were made public.

This is incredibly exciting news if it holds,” said Watson, “At the end of the day this is a very unique and unusual case.

“But what we can learn from the findings from this one patient will hopefully help progress a lot of the understanding of HIV in terms of so called latent reservoirs and whether or not it’s truly possible to see eradication of HIV in a positive population.”