In March, a team of scientists and doctors from the UK announced in London that the second HIV-positive man had been in remission from HIV for a long time (18 months) after receiving treatment for Hodgkins’ lymphoma. This unexpected success has led to a new round of discussions about the cure of HIV.
Since 2008, scientists have been trying to replicate the treatment of “Berlin patients” with HIV. At that time, many people in the field of HIV research were excited to learn that the man appeared to have cured his HIV. He tested positive for human immunodeficiency virus in Berlin and recently received treatment for acute myeloid leukemia. So far, the success of replicating this treatment has been limited.
What is HIV?
HIV is the virus that causes AIDS. Since HIV was first discovered in the 1980s, more than 75 million people worldwide have been infected with HIV. Today, about 37 million people are living with HIV. About 1.1 million of them live in the United States. HIV infection almost always leads to AIDS, which is almost always fatal. In 1996, revolutionary changes took place in this field with the advent of anti-retroviral for HIV. These drugs can prevent HIV replication and restore infected people to a normal immune system. These drugs are so effective that the life expectancy of an HIV-infected person today is almost the same as that of people who are not infected with HIV.
However, these drugs must be taken every day and have a variety of painful side effects that can cost thousands of dollars a month. Even with this life-prolonging treatment, functional HIV treatment is still difficult to achieve. Functional HIV treatment is defined as when people living with HIV no longer detect HIV positive and no longer need to take these drugs.
Related research report
In 2008, at the Retrovirus and opportunistic infections Conference in Boston, everything seemed to have changed as soon as it appeared that a Berlin patient named Timothy Ray Brown had been cured. In order to achieve this unexpected cure, Brown had to actively treat his acute myeloid leukemia, including two hematopoietic stem cell transplants (one of the patient’s bone marrow damage) and systemic irradiation. This complex treatment involves destroying a person’s immune system with high doses of chemotherapy or radiotherapy and then receiving new stem cell transplants from themselves or donors. This is a difficult treatment, with a high risk of infection and other complications, such as graft-versus-host disease, blood clots, and liver disease.
Present and Future
Given the recent disappointment in hematopoietic stem cell transplants in HIV patients, the team reporting remission in London did not describe the patient as a cure. So no one else should describe it that way. While the news of remission in the second patient with HIV treated for less toxic cancer is encouraging, 18 months of remission does not amount to a cure.
In addition, although the London patient’s cancer treatment is less intense, only chemotherapy and stem cell transplants, it is still toxic and is not the treatment process for healthy people living with HIV. Most importantly, the HIV community should recognize that cases of Brown are not uncommon. This gives us another-perhaps bigger reason-to look forward to a future revolution on the scientific path to the cure of AIDS.
References
1. Layer, E. H., Kennedy, C. E., Beckham, S. W., Mbwambo, J. K., Likindikoki, S., Davis, W. W., … & LTC Tanzania Collaborative Study Team. (2014). Multi-level factors affecting entry into and engagement in the HIV continuum of care in Iringa, Tanzania. PloS one, 9(8), e104961.
2. Kermode, M. (2019). HIV-related knowledge, attitude & risk perception amongst nurses, doctors & other healthcare workers in rural India.