A man diagnosed with HIV in the 1980s appears to have been completely cured of the virus. This is only the fourth such case in medical history.
As part of his leukemia treatment, the patient received a bone marrow transplant from a donor who had a rare DNA mutation that makes people resistant to the virus. The recovered man, who asked not to be named, is now 66 years old. And he no longer needs to take the drugs needed to neutralize HIV in his body.
According to him, when he found out that he no longer had the virus, he felt immense gratitude. Doctors called him the “patient from the City of Hope” – sometimes figuratively referring to the California town of Duarte where the man was treated. Many of the friends of the man who recovered did not live to see the invention of antiretroviral therapy, which fundamentally changed the length and quality of life for people living with HIV.
The human immunodeficiency virus (HIV) damages the immune system. This can lead to Acquired Immunodeficiency Syndrome (AIDS), where the body eventually becomes unable to fight off infections. “When I was diagnosed with HIV in 1988, like many others at the time, I thought it was a death sentence,” says a man who has been cured. “I never thought I would see the day when I would no longer have HIV.”
However, the patient was not being treated for HIV, but for leukemia – one of the most common types of blood cancer. The medical team decided that the then 63-year-old man needed a bone marrow transplant to replace the cancerous blood cells with new ones. By a stroke of luck, the donor had a rare natural mutation that made the cells resistant to HIV.
The virus enters our white blood cells through a microscopic “door” – a protein called CCR5. However, some people – including, it turns out, the donor himself – have lost the DNA fragment that allows the virus to do this during evolution. Therefore, HIV cannot physically enter their cells.
The City of Hope patient was closely monitored after the transplant. The virus gradually disappeared from his body. Currently, the man has been in remission for 17 months. “We were very happy to tell him that his HIV was in remission and that he no longer needed the antiretroviral therapy he had been taking for 30 years,” says Dr. Jane Dicter, an infectious disease specialist from Duarte, “the city of hope.
The first man in history to be cured of HIV was Timothy Ray Brown, who became known as the “Berlin Patient” in 2011. There have been three similar cases in the last three years. “The patient from the City of Hope” – both the oldest of the four and the one who has lived with his diagnosis the longest.
However, bone marrow transplantation will not revolutionize the treatment of HIV, which currently infects approximately 38 million people worldwide. “This is a complex procedure with a serious risk of side effects, so most people living with HIV cannot undergo it,” says Dr. Dicter. However, scientists are investigating the possibility of targeting the CCR5 protein through gene therapy. Research on this topic was discussed at the recent HIV treatment conference in Canada. Professor Sharon Lewin, president of the International Society for AIDS Research, commented on the “cure for the patient from the city of hope,” noting that the cure for HIV “remains elusive to scientists, the Holy Grail. “In the past, we have seen several individual cases of [cure] that have given hope to people living with HIV and inspired the scientific community.”