Cure

"In conclusion, our results strongly suggest that cure of HIV has been achieved in this patient."

Whew! Don't we wish we could report that about any one of the folks that we are working with at Jeevan Sahara Kendra.

Two weeks ago clinical scientists in Germany reported that very statement in the scientific journal Blood. Needless to say the news made headlines world wide.

The man they had been working with has been known for the last 2.5 years as 'the Berlin patient.' He is an American living in Germany who had been treated for a form of acute myeloid leukemia using a bone marrow transplant. Instead of only treating the cancer, the clinicians chose to see if something could be done about his HIV infection too.

It is known that about 1 in 1000 Europeans have a genetic condition which makes them resistant to HIV infection. This 'defect' is called the CCR5 delta-32 deletion.

To quote the article from AIDSMeds.com: This defect prevents CD4 cells from developing a receptor, called CCR5, on their surfaces. People who inherit this genetic mutation from both parents have CD4 cells that lack the CCR5 entirely and, as a result, are highly resistant to HIV

The physicians were able to find a bone marrow donor whose parents both had the mutation.

Following standard therapy, they then destroyed most of the patient's remaining white blood cells and gave further immunosuppressant drugs in order to acheive maximal acceptance of the bone marrow transplant. The transplant using what was hoped to be HIV resistant stem cells was conducted 20 months ago. The physicians stopped the patients' ART retroviral therapy at that point.

A relapse of the cancer 13 months later forced them to repeat the procedure of destroying the white blood cells and doing another transplant from the same donor.

The new cells 'took' successfully. The doctors have now reported that there is no sign of the leukemia anymore. And there is also no sign of active HIV.

This is a huge breakthrough - because it was assumed that reservoirs of HIV infection in different parts of the body would recolonise the person later. But this seems to have been thwarted by the newly resistant white blood cells.

The man - who last week revealed his identity as Timothy Ray Brown (picture above) in an interview with the German magazine Stern - is now recognised as having been cured of HIV/AIDS.

That he almost died a number of times during his treatment - especially after the relapse of leukemia - does not take away from the wonder of the achievement.

At the same time, we are not expecting any flood of treatments anytime in the near future. Commentary from various sources points out the obvious: It worked for Timothy Ray Brown - but not everyone could undergo the rigours of twice going through the chemo- and radiation-therapy that he did to receive the marrow transplants. And further - the vast majority of people living with HIV cannot dream of the resources needed to undergo such a set of interventions.

Still - just the thrill of hearing a set of august scientists concluding that for this person at least - a therapuetic cure has been achieved - is worth celebrating.

The thrill of seeing a man who has been cured - is something to be very glad about.

There is at least 1 Nobel prize in medicine still awaiting the team that develops a reasonable and replicable curative treatment for HIV.

This month we may have seen a small step towards what we are praying for.