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Home Columns Just*in Time: 5 Simple Facts About HIV Remission & the London Patient
Just*in Time: 5 Simple Facts About HIV Remission & the London Patient
Photo by Jessica Bolton
As the news came out about the London patient being cured of HIV, I thought of the whole question of HIV achieving remission. Just twelve years ago I remember hearing about Timothy Ray Brown, the Berlin patient (whom I know personally). The London patient and the Berlin patient were both cured by the same procedure. Both men had a bone marrow stem cell transplant to treat cancer. Both of the men got bone marrow from an HIV-resistant donor. Also there is a third man from Dusseldorf, Germany, that had a similar bone marrow stem cell transplant to treat cancer and got bone marrow from an HIV-resistant donor. The Dusseldorf patient has been off his HIV medications for three months now but there isn't enough time to say that this patient has been cured.
We should keep in mind what a "cure" means in the context of the everyday realities of people living with HIV/AIDS.
5 Simple Facts about One Cure Approach for HIV
1. It's super rare. Before both successful attempts to cure HIV there were many failed attempts in many patients. First the transplants from a HIV-resistant donor would be few and far between. Bone marrow transplants are also very risky; most doctors only perform this operation when there is a clinical reason, which would be cancer in these cases.
2. There must be a genetic match between the bone marrow donors and recipients. According to the U.S. Library of Science the C-C chemokine receptor type 5 (CCR5) is predicted to be a seven transmembrane protein similar to G protein-coupled receptors. This protein is articulated by T cells and macrophages, and is known to be an significant co-receptor for macrophage-tropic virus, including HIV, to enter host cells. Defective alleles of this gene have been associated with the HIV infection resistance. Basically, both people involved in the operation have to have a matching CCR5 mutations.
3. CCR5 mutation is rare in itself. Professor Christopher Duncan told Science Daily that, "The fact that the CCR5-delta 32 mutation is restricted to Europe suggests that the plagues of the Middle Ages played a big part in raising the frequency of the mutation. These plagues were also confined to Europe, persisted for more than 300 years and had a 100% case mortality." Basically all people in that part of the world have a greater chance to have the match for the CCR5 that is HIV-resistant.
4. Americans not finding a cure of HIV could have something to do with it being the melting pot of the world. If there is a cure for HIV that could be found elsewhere other than in Europe, the United States hasn't found it yet. If it's hard for the Americans to find this cure then we will need to generate more funding and more HIV research. The problem with that is the current Administration has halted certain HIV research, such as the study that would use fetal tissue to attempt to discover a cure for HIV. According to the Washington Post, the study was shut down because it uses fetal tissue implanted into mice.
5. Even though the HIV cure is rare and I might not see one that I can take in my lifetime, it gives me hope for the future. It gives hope for the younger generation who aren't really educated on the cure or HIV itself. Right now HIV is something that some of us have to live with. I take one pill a day with food to suppress my HIV and that looks as if that is what I will have to do for the rest of my life, and I'm okay with that. However, other people are not okay with that. No matter what, we need more funding for more HIV research; there has to be a cure out there for everyone, not just people from a certain part of the world. I still have hope.
Justin B. Terry-Smith, MPH, DrPH, has been fighting the good fight since 1999. He's garnered recognition and awards for his work, but he's more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children's book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, "Justin's HIV Journal": justinshivjournal.blogspot.com. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].
HIV Cure
London Patient
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