Health column: The cure for HIV

Fri, 03/22/2019 - 6:30am
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An un-identified code-named “Patient London” has become the second person in the world cured of HIV/AIDS as reported by Reuters and The New York Times [1]. If you, like me, are amazed at the word “cured” in relation to AIDS, then we’re in alignment.

Like so many scientific discoveries, this one happened by accident.

Timothy Brown, the first patient cured of HIV, also had a concurrent leukemia. He received a bone marrow transplant to treat the leukemia, the complications of which nearly killed him. But the bone marrow he received contained what is called a CCR5 mutation that would inhibit any further replication of the HIV virus. Once scientists found this mutation, they wanted to replicate it.

They have successfully done so with “Patient London.”

In addition to HIV, “London” has a cancer: lymphoma. He was then entered into a small trial of patients eligible for a bone marrow transplant that also had this special CCR5 mutation that would treat both lymphoma and HIV.

He remains free of HIV three years out from the bone marrow transplant and has stopped taking all other HIV medications [2].

Now, of course, while remarkable, a treatment like this is hardly generalizable to all HIV patients, the vast majority of whom don’t otherwise need bone marrow transplants. But relative to what we could do only 30 years ago, this is an astounding development for future research.

I am training in an era full of historical horror stories about HIV and AIDS. Most of my seniors, especially infectious disease specialists, recount how, during their residencies, a positive HIV test meant family meetings and a death sentence. Once my mentor reminisced on his experiences at NYU’s Bellevue Hospital, ground zero of the AIDS epidemic. His eyes hardened and became glassy as the faces of countless patients rolled through his memory. They became infected with HIV at the wrong time in history.

Popular films like “Dallas Buyer’s Club” and more recently “Bohemian Rhapsody” have immortalized characters who succumbed to HIV — but not before a fight. Whether it was through aggressive investigations into new treatments, an FDA battle with Matthew McConaughey’s Ron Woodroof in “Buyer’s Club,” or a struggle to revolutionize the world of rock’n’roll with Rami Malek’s Freddie Mercury, heroes came to the fore in the HIV story. This latest “Patient London” is a palpable reminder that their memories and the memories of all those affected by the HIV epidemic remain the fuel for future discovery.

[1] Reuters. "London HIV Patient Becomes World's Second AIDS Cure Hope." 

[2] Reuters. "London HIV Patient Becomes World's Second AIDS Cure Hope."