30 years after first AIDS cases, hope for a cure
Marilyn Marchione | 6/8/2011, 1:27 a.m.
Several months later, the return of leukemia changed their minds.
Brown discussed the transplant with his boss “and she said, ‘wow, this is amazing. Because you have leukemia, you could be cured of HIV.’”
A registry turned up more than 200 possible donors and Huetter started testing them for the HIV resistance gene. He hit pay dirt at No. 61 - a German man living in the United States, around 25 years old.
Brown had the transplant in February 2007. A year later, his leukemia returned but HIV did not. He had a second transplant in March 2008 from the same donor.
Now 45, Brown needs no medicines, and his only health problems are from the mugging he suffered two years ago as he returned home one night in Berlin. Brown was knocked unconscious, required brain surgery and therapy to walk and talk again, and doesn’t have full use of one arm. He moved back to the United States in December.
“He’s now four years off his antiretroviral therapy and we have no evidence of HIV in any tissue or blood that we have tested,” even places where the virus can lie dormant for many years, Huetter said.
Brown’s success inspired scientists to try a similar but less harsh tactic: modifying some of a patient’s infection-fighting blood cells to contain the mutation and resist HIV. In theory, this would strengthen the immune system enough that people would no longer need to take HIV drugs to keep the virus suppressed.
Scientists recently tried this gene therapy in a couple dozen patients, including Matthew Sharp of suburban San Francisco. More than six months later, the number of his infection-fighting blood cells is “still significantly higher than baseline,” he said.
It will take more time to know if gene therapy works and is safe. Experiments on dozens of patients are under way, including some where patients go off their HIV medicines and doctors watch to see if the modified cells control the virus.
The results so far on the cell counts “are all wonderful findings but they could all amount to nothing” unless HIV stays suppressed, said Dr. Jacob Lalezari, director of Quest Clinical Research in San Francisco who is leading one of the studies.
The approach also is not practical for poor countries.
“I wouldn’t want people to think that gene therapy is going to be something you can do on 33 million people,” said Fauci.
Other promising approaches to a cure try new ways to attack the dormant virus problem, he said. They hinge on getting people tested and into care as soon as they become infected.
Fauci’s institute has boosted money for cure research, and the International AIDS Society, a professional organization for those who work in the field, has added finding a cure to its strategic plan.
“There are paths forward now” to a day when people with AIDS might be cured, said Dr. Michael Horberg, president of President Obama's HIV/AIDS council and of the HIV Medicine Association, doctors who treat the disease. “But it’s not tomorrow, and it’s not today.”