HIV Cure Should Be Viewed with "Guarded Optimism"
Dr. Gero Hutter of Charite-Medical University in Berlin has reported that he has cured a patient of HIV with a bone marrow transplant. Although the news could potentially lead to more research into new treatments including gene therapy, Victor Maldonado of HealthHIV warns that the findings should be viewed with “guarded optimism.”
Bone Marrow Transplant Risky and Impractical
The study subject had acute myeloid leukemia (AML) in addition to HIV and originally received the bone marrow transplant in 2007. HIV entry into CD4+ cells requires interaction with a cellular receptor, generally either CCR5 or CXCR4. The stem cells the patient received from the donor were CCR532/32 cells, which increases immunity and prevents the HIV virus from entering cells. The mutation occurs in only one in every million people.
Dr. Hutter and colleagues, who published the research in the current issue of the journal Blood, said that they suspected that the patient may eventually have HIV rebound and disease progression, but the patient three years later remains without any sign of infection and has had successful reconstitution of CD4+ T cells.
“Although it may encourage hope that a cure is feasible,” said Dr. Douglas Richman, director of the Center for AIDS Research at the University of California at San Diego, “this approach in practice cannot be applied to the vast majority of patients.”
"We should be clear that this 'cure' will in fact have almost no impact on the average HIV-infected patient," adds Bert Jacobs, a professor at Arizona State University at Tempe.
Bone marrow transplants are expensive and potentially dangerous, say medical experts. The mortality rate is approximately 30% when used in cancer patients.
It should also be noted the patient had intense chemotherapy and radiation, then given a second transplant from the same donor because the AML had relapsed after 13 months. It is possible he could still rebound with HIV in the future.
Mr. Maldonado, who has HIV himself, said that he is grateful for major medical accomplishments of the past few decades, including antiretroviral therapy. He also hopes that research studies like the one in Germany will continue to push toward a cure. “Research is the lifeblood for finding treatments and a cure for HIV,” he said.
Rowena Johnston, director of research at the Foundation for AIDS Research says that “It’s not just a pipe dream any more, somebody has been cured and we need to work out how we can come up with a cure that will be more readily available to everybody out there who needs it.”
There are currently over 30 million people living with HIV.