Two patients clear of HIV after stem-cell transplants

Researchers in Boston say it is too early to conclude the men are ’cured’

Two HIV patients in Boston who received stem-cell transplants for cancer had no trace of the AIDS-causing virus after the procedure. Photograph: World Aids Day

Two HIV patients in Boston who received stem-cell transplants for cancer had no trace of the AIDS-causing virus after the procedure. Photograph: World Aids Day

 

Two HIV patients in Boston who received stem-cell transplants for cancer had no trace of the AIDS-causing virus after the procedure, suggesting they may have been cured.

The two patients, treated at Brigham and Women’s Hospital, stopped HIV treatment after the transplants, which in other patients has opened the door for the virus to come roaring back.

In one patient there was no sign of the virus 15 weeks after stopping treatment, while the other has gone seven weeks without HIV rebounding, according to results presented today at the International AIDS Society’s meeting in Kuala Lumpur.

The researchers led by Timothy Henrich of Harvard Medical School and Brigham and Women’s Hospital said it is too early to conclude the two men have been cured and the virus may be lingering in their brains or gut.

Still, their cases are similar to that of Timothy Brown, the so-called Berlin patient, who was the first person to be cured of HIV after getting a bone marrow transplant for leukemia in 2007.

“While stem-cell transplantation is not a viable option for people with HIV on a broad scale because of its costs and complexity, these new cases could lead us to new approaches to treating, and ultimately even eradicating, HIV,” Kevin Robert Frost, the chief executive officer of amfAR, The Foundation for AIDS Research, which funded the study, said in a statement.

Drug Cocktails

There was one main difference between Brown and the two Boston men: the cells he received contained a rare genetic mutation called CCR5 that made him resistant to HIV infection. The donors in the new cases lacked that mutation, and the Boston patients didn’t undergo the intensive chemotherapy Brown did.

Scientists had believed the CCR5 mutation was key to Brown being cured. They will be scouring the new evidence for clues to whether other genes may hold promise against HIV, Rowena Johnson, amfAR’s director of research, said.

While AIDS drugs such as Gilead Sciences’s Atripla reduce HIV to undetectable levels in the body, making it a chronic disease, they don’t completely clear it. The virus hides in certain immune cells, where it switches off the normal process of replication. That enables HIV to avoid detection by the medicines, which are designed to block steps in its reproduction.

Studies have shown that when patients who have the virus under control stop treatment, latent HIV reactivates and comes roaring back, forcing victims to resume daily pill therapy.

Doctors in March said they had cured an infant born with HIV for the first time by treating her with AIDS drugs about 30 hours after she was born at a rural Mississippi hospital. At 18 months the mother took the child off medication, and when the virus had not returned 10 months later, she was deemed “functionally cured.”

Bloomberg