December 15, 2010
Stem cell transplant -- the cure for HIV? Photo: thinkprogress.org.
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.