Tentative HIV "Cure" Presents a Guarded Sense of Hope
By Candace Y.A. Montague
December 15, 2010
On the heels of two major medical breakthroughs in HIV research this year (vaginal gel Tenofovir and the antiretroviral Truvada pill) comes a third development. Scientists in Germany have declared that they have found a potential cure for HIV and leukemia simultaneously. The announcement, originally published in a peer-reviewed journal called Blood, broke yesterday. In the journal, doctors in Berlin say they have found an agressive yet effective treatment that would restore a patient's T-cell count to one that would equal a person who is HIV negative. American scientists, while pleased, are very cautious about celebrating the news just yet.
The patient, a 44-year-old American named Timothy Brown, underwent treatment for HIV and his acute myeloid leukemia, (a cancer of the immune system) in 2007. Using stem cells from an adult donor (no embryos) who had an inherited gene mutation that left his body without the gene receptors involved in contracting HIV, Brown's doctors chose to use a stem cell transplant in lieu of the traditional stem cell therapy used for leukemia patients. They expected to treat his HIV while working on the cancer. After three years of study, the results were that Brown maintained a high CD4 count and no signs that the HIV was replicating in his system. The authors of the report concluded "the patient remains without any evidence for HIV infection since more than 3.5 years after discontinuation of ART (antiretroviral therapy). From these results, it is reasonable to conclude that cure of HIV infection has been achieved in this patient."
Brown had endured intense chemotherapy and full-body radiation to fight his leukemia. This kind of treatment is damaging to the immune system but can also help it become more receptive to new, HIV-resistant stem cells. Dr. Margaret Fischl, top AIDS researcher at the University of Miami, says "I would call this a functional cure. It's on the level and a very remarkable case. But would we do this with an HIV patient? No." The treatment is very debilitating and is above and beyond what most doctors would recommend to handle HIV. Dr. Michael Saag, researcher at the University of Alabama at Birmingham says, "We can't really apply this particular approach to healthy individuals because the risk is just too high. Especially when drugs can keep HIV in check in most cases. Unless someone with HIV also had cancer, a transplant would not likely be considered." Still, most doctors are excited about the news of a potential cure. No one is probably more excited than Timothy Brown who took a risk and in return has been given a second chance at life.
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Comment by: Scandinavian American
(New York, NY)
Sat., May. 28, 2011 at 12:37 am EDT
Fascinating. Hopeful. As a Scandanavian American who is already listed in the bone marrow registry, I would love if all the samples were tested for the genetic variation. Maybe Amfar could do a call for (1) Scandanavian Americans to give blood for the bone marrow registry and pay the extra amount for that extra test. (2) Ask Scandanavian Americans already in the bone marrow registry to donate $ to cover the cost of that test on our own blood so we might be able to help this way.
Comment by: Eddie
Mon., Dec. 20, 2010 at 4:14 pm EST
If I remember well in '95 there was a guy who had a baboon bone marrow transplant performed by Dr.Stephen Deeks.Correct me if I wrong, but this patient fought to get that transplant done knowing that his possibilities to live were slim to none. It didn't work. Granted, that same year the world saw the birth of HARRT. Eventually that patient would die of AIDS complications in 2001. But If he was still alive today, I bet you anything he would fight to get this stem cell transplant, even if there was a 40% survival chance. My point is that we have to fight in trying to get better treatments or a cure, even if we have to pay the ultimate price. To me, when you are HIV positive, nothing should scare you, nothing really matters, and the risks can't be any riskier. So no, I don't buy the "It is too risky for HIV+ patients". Please give us the chance to come back from the edge.
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Comment by: Lawrence
Mon., Dec. 20, 2010 at 8:26 pm EST
Are you people for real? Before you start demanding stem-cell replacement and babboon marrow, I strongly suggest you read up on some of the "comorbidities" Mr. Brown has experienced. For all your internet tough-talk about medical providers needing to be infected so that they may feel our pain, I've had an awfully hard time finding other pozzies in real life who will so much as sign a damn letter petitioning for a cure. The fact of the matter is that The Berlin Patient has been to Hell and back for something which may not have even completely voided the virus from his body, and no one really knows what his long term prospects are. You're so concerned about deterioration? Brown is still having a hard time walking and talking. Here's an idea...get off the damn internet and stop whining about what your HAART is doing to your body, and go to a support group...or hell, any poz website...to brainstorm what you can do to achieve a cure. If that's too much, try donating to amFar or writing the NIH to increase cure research.
Comment by: bob
Tue., Dec. 21, 2010 at 7:35 am EST
lawrence, i'm sure that support groups will cure hiv and stop the criminalization. i believe that what most is annoyed at is not HAART, but how complacent it has become because the attitude has become "it's good enough" or "it's managed"....and not "it's cured".
but please, be satisfied with where you are when your lings collapse and you can't remember if you took your atripla that day or not or a condom broke and your lover demands you go to prison or your kidneys fail....be satisfied with the status quo.
Comment by: Lawrence
Tue., Dec. 21, 2010 at 12:00 pm EST
When my "Lings" collapse? Seriously? Honey, my Ling already collapsed on April 30, 2008. He remains in our memory as a Bamboo-munching symbol of China and the generosity of its people. Did you mean to inform me that my "lungs" will collapse? I'm not ignorant of the long term consequences of this virus, though I'm confident my negative partner would have a harder time putting me in jail than yours, as I don't have a history of wishing HIV on those who don't appreciate my pain. Regardless, I'm well aware of the stigma we face, as well as the "comorbidities" (Thanks NYC AIDS commercial!). In response I've done what little I can think to do to help push us make progress. In fact, even my previous response to you included a call to action, and suggestions about how you can help move us closer to our goal. Rather than mislabeling that as complacency, tantrumming against researchers and glorifying the desperation that existed pre-HAART, why don't you present some suggestions of your own to help us organize for a cure? If we're not going to find other people interested in a cure at support groups, where would you suggest we find them? Need motivation? Time is of the essence and current research isn't gonna help you: In "thoughts on the Berlin Patient" this very website speculates on a cure rollout within 10-20 years (http://www.thebody.com/content/art53674.html), and will start with emphasis on the small handful who began treatment during acute infection. In other words, it'll be worthless to most of us. Now THATS reason to scream at researchers! My post was intended to put this "cure" into perspective and to point out that many of the people who are reacting so favorably towards anything with the word "cure" in it seem bent on cutting off their nose to spite their face. It expressed frusteration at the fact that for all the internet tough-talk, I've met few pozzies who really seem to want to make a difference.
Comment by: Michael
Sat., Dec. 18, 2010 at 1:22 pm EST
I am glad this is finally getting some coverage from the mainstream media. I also hope that this leads to a race for a cure amongst nations, like the good old space race between the Russians and the Americans after WWII.
Comment by: john316
Fri., Dec. 17, 2010 at 6:31 am EST
well said michael well said. this docs make this claims because they are not infected and dont know what a person with hiv goes through. any person with hiv would take that "just to high" risk in order to be cured. to bad big pharma has all of the docs in their pocket and has them say that patient on current treatment do just fine.
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Comment by: John
Wed., Dec. 29, 2010 at 11:44 pm EST
I would not. I was diagnosed HIV+ about 2 years ago. I am on a very powerful regimen of Truvada and Isentress and it works-- very well. My T Cell counts are very good and my VL remains undetectable. There obviously are no guarantees for what is going to happen in 5, 10, 20, 30, or 50 years. However, no one gets those kinds of guarantees in life. I am in great health now, and so long as I adhere to medication, there is no reason to believe that I will not continue to be for many more years. To do a drastic surgery that involves killing my present immune system to have a chance at "curing" the virus is a very dangerous gamble when there are much safer alternatives available now.
Yes, these drugs cost a lot. However, these drug companies have saved the lives of those of us with HIV and AIDS. Therefore, your criticism on the drug companies is misplaced.
Comment by: kawsar
Thu., Dec. 16, 2010 at 8:49 pm EST
a news of hope and joy.
Comment by: dave
Thu., Dec. 16, 2010 at 2:42 pm EST
If this intervention is being touted as "potential cure," how can this claim be made if "we can't apply this to healthy patients..." So my question remains, How is this a potential cure? This is unfair journalism!
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Comment by: Candace Montague
Thu., Dec. 16, 2010 at 8:32 pm EST
First of all thank you so much for reading and providing some feedback. I honestly appreciate hearing your opinion. Second of all I put the word cure in quotes to indicate that the scientists believe that this is a cure. I am certainly not claiming this to be a cure. From what I can tell, this is just one instance of a treatment that worked with a man who was terribly ill. I added quotes from the American doctors to show that there are other perspectives to consider. As far as I'm concerned, we've got a long way to go before we claim victory.
Again thanks for your feedback.
Comment by: michael
Thu., Dec. 16, 2010 at 7:34 am EST
dr saag of university of alabama...the risk is just too high? why don't we infect you with hiv and go thru haart everyday of your life and see you body deteriorate, side effects of the meds alone, not to mention the mental aspect....we're not even gonna go though the psychological aspect and how the non cured hiv patient is discriminated against, even put in jail.....and you consider the risk as "just too high?"
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Comment by: Chris
Fri., Dec. 17, 2010 at 4:36 am EST
Have you looked at the figures involved with the procedure? The Leukemia treatment alone has an almost 20% mortality rate - in patients *not* co-infected with HIV.
A 1 in 5 chance of dying from treatment alone - with no guarantee of the treatment actually curing the Leukemia, let alone the viral infection *is* too low in most people books.
What this paper has shown though is that there is definately hope in the field of Gene Therapy using resistant stem cells in curing HIV - now it's gone from a "Can we cure?" to a "How do we roll this out?"
I'll take that any day of the week
Comment by: karen
Mon., Dec. 20, 2010 at 4:53 am EST
Chris, read your post. Then, re-read it again. Apply those statistics to everyday applications of what a typical hiv infected person goes through.
I actually read about this story last year and there was actually a backlash against it. You know what the reason for the backlash against the "hiv expert community" was? That this "cure" was discovered by an ordinary doctor who is not an expert in infectious disease or hiv.
This story never hit the mainstream media.
It's kind of ironic. When did we start to accept hiv patients on HAART as healthy individuals? Since when has it become acceptable for a person taking toxic medicine everyday of his life, going to a specialist every few months, and having drawn out of them *up to six to eight tubes of blood) every few months a healthy individual? I guess "healthy hiv people" are accepted better in society nowadays.......
So Chris, if these are all acceptable to you and you are willing to take this "any day of the week", then perhaps you have more days than the rest of the hiv community.
On a side note, procedures can be perfected as with all things. Opposite side of the coin, it's a new approach with an 80 percent survival rate.
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Candace Y.A. Montague
Candace Y.A. Montague has been learning about HIV since 1988 (and she has the certificates from the American Red Cross to prove it). Health is a high priority to Candace because she believes that nothing can come of your life if you're not healthy enough to enjoy it. One of her two master's degrees is in Community Health Promotion and Education. Candace was inspired to act against HIV after seeing a documentary in 2008 about African-American women and HIV. She knew that writing was the best way for her to make a difference and help inform others. Candace is a native Washingtonian and covers HIV news all around D.C. She has covered fundraisers, motorcycle rides, town hall meetings, house balls, Capitol Hill press conferences, election campaigns and protests for The DC Examiner.com and emPower News Magazine.
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