By Melissa Hiebert (The Martlet)
Will we cure HIV in our lifetime?
VICTORIA (CUP) — The human body can do many amazing things: heal cuts, fight off diseases, and bear the consequences of our impulsive actions. But our bodies have many limitations. There are some things that have so far evaded both the body’s natural resilience and years of man’s mental ingenuity.
Since before its official recognition in 1981, human immunodeficiency virus (HIV) has been one of the most evasive and widespread viruses in the world. For years it has been believed that, while we could manage HIV by maintaining a sort of rocky co-existence between the virus and our bodies, a cure would never be found.
In 2009, Timothy Brown — for years known only to the public as “The Berlin Patient” — became the first man in history to be declared cured of HIV.
Two threats, one treatment
Seattle-born Timothy Brown was living in Berlin when he contracted HIV in 1995. Fortunately, the advent of new anti-retroviral drugs in 1996 allowed people with HIV to live longer and healthier lives. Brown became used to this relatively healthy life until, in 2006, he developed a second life-threatening disease: leukemia.
After an initial bout of chemotherapy, Brown’s leukemia started to go into remission. However, when it returned in January 2007, it became clear that a stem-cell transplant was necessary.
It was around this time that Brown’s oncologist, Gero Hutter — who had no previous background in HIV research — made a suggestion that would eventually materialize into a possible cure for one of the world’s most devastating diseases — for one man, at least.
Hutter had casually come across studies that showed the HIV virus attaches itself to immune system response cells in our body called T-cells . When HIV takes over enough of these cells, the viral infection develops into AIDS and leaves the body fatally vulnerable to even the most placid illnesses.
However, people with a particular genetic mutation that’s present in about one per cent of the European population do not have the CCR5 receptor — the major co-receptor that HIV uses to infect the body. These few have a natural resistance to HIV. In a flash of ingenuity, Hutter had the idea to take advantage of Brown’s impending stem-cell transplant and use cells from someone with this HIV-resistant mutation.
His ingenuity paid off: Brown stopped taking his HIV drugs the day of the transplant and never took them again. After repeated tests, an article was published in the New England Journal of Medicine, tentatively declaring Brown cured of HIV.
The Berlin Patient speaks
Brown says that he was initially reluctant to attempt the treatment.
“My initial thoughts were that I basically just wanted to be cured of the leukemia,” says soft-spoken Brown, recalling the first time the experimental treatment came up. “I thought it was a great idea, but I didn’t really believe that it would work.”
At first, Brown turned down the stem-cell transplant option — stem-cell transplants are notoriously difficult on the body, and incredibly risky. When it became clear that there were no other options, Brown consented to receiving the transplant.
Brown is now both leukemia- and HIV-free. He still undergoes regular testing to ensure that the virus is not present in his body, and also gives regular blood samples to medical researchers across the United States.
Yet there is some controversy over whether or not Brown is completely rid of the virus. This past June, a San Francisco-based research group claimed that they had in fact detected very low levels of infected cells in samples they had collected from Brown. However, the report they published states that it is “impossible to conclude” that Brown remains infected. This, coupled with the lack of similar findings from other labs, and that the viral genes don’t completely match samples of Brown’s HIV before the transplant, suggest that the test results may be due to a sample contamination.
Regardless of whether or not the findings are accurate, Brown is still considered functionally cured, meaning that even if some virus particles remain present, the virus is not actively replicating.
For years Brown was reluctant to make his identity public. “I did an interview in 2009 with a German newspaper. When I did that interview, I asked them not to use my name,” says Brown, who was still recovering. “I began to realize in 2010 that I needed to come out and be an advocate for other people to find a cure for HIV.”
The Timothy Ray Brown Foundation
Since 2010, Brown has focused on being an activist for the cure of HIV. Brown’s specific cure is not practical on a wide-range scale (due to its high risk, shortage of donors, and cost), but researchers are taking what they’ve learned from Brown’s case and are attempting to use that knowledge to work on more feasible cures. For instance, Brown mentions one attempt that focuses on removing HIV-susceptible receptors from T-cells without resorting to a transplant.
In July, Brown announced his new foundation, the Timothy Ray Brown Foundation, the only charity with the sole purpose of securing funds for cure research. Because modern-day anti-retroviral drugs are effective, and an ultimate cure for HIV was previously thought impossible, most research is geared towards improving these sorts of drugs. Studies have shown that the average life expectancy of those who receive an early diagnosis and proper treatment is only around seven years shorter than someone without the virus.
Despite the significant increase in life expectancy, however, both Brown and one of the co-founders of The World AIDS Institute, Chad Johnson, are adamant that one of the most important tasks for those living with HIV is to work towards finding a cure.
“From my perspective, the way that we can really help people is that we can be investing a whole lot more resources into finding a cure,” says Johnson, who has been involved in civil rights work for over 20 years. Johnson notes that although the United States government is planning to invest $2 to $3 billion into cure research in the next two years, it’s not enough.
“We’re really behind the game,” says Johnson. “Look at [Brown’s] example and you can see there is a cure. If there is one person who can be cured, we can cure this thing. All we need is the right political and social will to make it happen. Our job is to make sure that hope is out there.”
Spreading the cure
The possibility of finding a cure seems more likely all the time. At the International AIDS Conference this year, researchers from Harvard presented a report detailing the cases of two other patients who underwent a similar procedure to Brown. So far, no traces of the virus have been found in their blood samples. However, researchers maintain that it is still too soon to claim that they have been cured.
The main difference is that, while Brown’s stem cells came from a donor with the CCR5 mutation, the two other patients’ donors did not, demonstrating the CCR5 mutation might have helped with Brown’s cure, but it may not be necessary to the procedure.
Wherever this research leads, it has given people living with HIV hope for the future. Brown’s best advice for those living with the virus: “Don’t give up hope, because a cure is on the horizon.”
Brown’s story is one that documents both the unique ability of human ingenuity to step in and help cure the body when it is unable to cure itself, and the resilience of body and spirit. After surviving two life-threatening illnesses and narrowly escaping death several times, Brown’s outlook remains positive.
“I joked to a friend of mine that I have nine lives, and he said I have at least a hundred,” says Brown. “I live my life as if I will live forever. Hopefully I will live for a long time. And I hope to be alive when there’s a cure for HIV for everyone.”
