Two cancer patients in Boston who were also infected with HIV have no trace of the virus after receiving stem-cell transplants, suggesting they may have been cured of the AIDS-causing infection.
The two patients, treated at Brigham and Women’s Hospital, stopped HIV treatment after the transplants, which in other patients has opened the door for the virus to come roaring back. In one patient there was no sign of the virus 15 weeks after stopping treatment, while the other has gone seven weeks without HIV rebounding, according to results presented today at the International AIDS Society’s meeting in Kuala Lumpur.
The researchers led by Timothy Henrich of Harvard Medical School and Brigham and Women’s Hospital said it’s too early to conclude the two men have been cured and the virus may be lingering in their brains or gut. Still, their cases are similar to that of Timothy Brown, the so-called Berlin patient, who was the first person to be cured of HIV after getting a bone marrow transplant for leukemia in 2007.
“While stem-cell transplantation is not a viable option for people with HIV on a broad scale because of its costs and complexity, these new cases could lead us to new approaches to treating, and ultimately even eradicating, HIV,” Kevin Robert Frost, the chief executive officer of amfAR, The Foundation for AIDS Research, which funded the study, said in a statement.
There was one main difference between Brown and the two Boston men: the cells he received contained a rare genetic mutation called CCR5 that made him resistant to HIV infection. The donors in the new cases lacked that mutation, and the Boston patients didn’t undergo the intensive chemotherapy Brown did.
Scientists had believed the CCR5 mutation was key to Brown being cured. They’ll be searching through the new results for clues to whether other genes may hold promise against HIV, Rowena Johnston, amfAR’s director of research, said in an e-mail.
“This stuff is really very exciting scientifically, and it really captures the imagination of the patients,” said Paul E. Sax, a professor of medicine at Harvard Medical School and a clinician at Brigham and Women’s. “All of us get asked by our patients about these cases, even to the point of people actually requesting bone marrow transplants.”
While AIDS drugs such as Gilead Sciences Inc.’s Atripla reduce HIV to undetectable levels in the body, making it a chronic disease, they don’t completely clear it. The virus hides in certain immune cells, where it switches off the normal process of replication. That enables HIV to avoid detection by the medicines, which are designed to block steps in its reproduction.
Studies have shown that when patients who have the virus under control stop treatment, latent HIV reactivates and comes roaring back, forcing victims to resume daily pill therapy.
Doctors in March said they had cured an infant born with HIV for the first time by treating her with AIDS drugs about 30 hours after she was born at a rural Mississippi hospital. At 18 months the mother took the child off medication, and when the virus had not returned 10 months later, she was deemed “functionally cured.”