Strangely enough, the diagnosis that most concerned Timothy Ray Brown in 2007 was acute myeloid leukemia. HIV has been increasingly thought of as a manageable disease, though certainly a terribly burdensome one. What brought the 42-year-old Brown under the care of Germany’s Charite Universitatsmedizin Berlin hospital was the more immediate threat his cancer posed.
The treatment Brown underwent was aggressive: chemotherapy that destroyed the majority of his immune cells. Total body irradiation. Finally, a risky stem-cell transplant that nearly a third of patients don’t survive – but that appears to have completely cured Brown of HIV.
Doctors were savvy when they chose a stem cell donor for Brown. The man whose bone marrow they used has a particular genetic mutation, present in an incredibly small percentage of people, that makes him almost invulnerable to HIV. With Brown’s own defenses decimated by treatments, the healthy, HIV-resistant donor cells repopulated his immune system. Three years later, having taken no antiretroviral drugs since the transplant, extensive testing shows no signs whatsoever of HIV.
What does this mean for the future of treatment? It’s not as though every HIV patient can or would want to go through the tremendous suffering that was prelude to Brown’s recovery. But for the first time, we know that HIV can be cured, not just managed. It opens new avenues of research – gene therapy, stem cell treatments—that may otherwise have been thought dead ends. [AIDS Map]