A cure for HIV? Feasible but not yet

A team of scientists and physicians from the UK recently published news of a second HIV positive man, in London, who is in long-term (18-month) HIV remission after undergoing treatment for Hodgkins lymphoma. The unexpected success has launched a new round of discussion about a potential cure for HIV.

Since 2008, scientists have been trying to replicate the treatment that cured the “Berlin patient” of HIV. At the time, many in the field of HIV research were excited to learn that this man, who tested positive for the human immunodeficiency virus in Berlin and had recently undergone treatment for acute myeloid leukemia, appeared to have been cured of his HIV. Until now, success in replicating that cure has been limited.

In 2008 at the Conference on Retrovirus and Opportunistic Infections in Boston, Massachusetts, the news broke of the Berlin patient, named Timothy Ray Brown, who seemed to have been cured of his HIV.

In order to achieve that serendipitous “cure,” Brown had to undergo aggressive treatment for his acute myeloid leukemia that involved two hematopoietic stem cell transplantations – in which a patient’s bone marrow is damaged – and full body irradiation.

This complex treatment involves destroying a person’s own immune system with high doses of chemotherapy or radiation. Then the patient receives a transplant of new stem cells from either themselves or a donor.

After receiving treatment, both patients were eventually taken off their anti-retroviral medications and subsequent examination showed that that even with very sensitive blood tests, the team could not detect HIV in their blood. The inability to find HIV in their blood, coupled with the missing CCR5 receptor, constitutes the HIV viral remission of the London patient announced earlier this month.

While a second patient experiencing HIV viral remission with a slightly less toxic cancer treatment is certainly encouraging progress, an 18-month remission does not equal a cure.

Also, while the London patient’s cancer treatment was less intense, with just chemotherapy and the stem cell transplant, it was still toxic and is not a course of treatment that otherwise healthy people living with HIV infection should embark upon.

Most importantly, the HIV community learned that Brown’s case was not unique. This gives us another, and perhaps greater reason, to hope for future revolutions in the HIV cure scientific agenda.

The author filed this report for The Conversation. She is Assistant Professor of Nursing, Case Western Reserve University