World AIDS Day 2021 Special
HIV is a lifelong infection with no cure. Or at least that is what conventional wisdom and in fact what conventional medicine tells us. If left untreated the HIV infection invariably leads to AIDS and death. Taking anti-retroviral medicines keeps the virus under control and prevents its replication. However, HIV virus that hides in so-called viral reservoirs in the body can never be eradicated. And that is why HIV cannot be cured. Or can it? Published scientific literature tells us of 5 people who have bucked this trend. The rarest of the rare – people who were cured of HIV. Let’s take a look at their stories.
The Berlin Patient
Timothy Ray Brown aka The Berlin Patient will forever go down in history as he first person ever cured of HIV. Timothy was born in Seattle Washington and was diagnosed with HIV in 1995 while studying in Berlin. 11 years later in 2006 he developed a cancer of the blood known as Acute Myeloid Leukemia. In an attempt to treat his Leukemia, he underwent a stem cell transplant. However, there was something very special about the person from whom the stem cells came. The stem cell donor had a very special and rare mutation in the CCR5 gene. This mutation changes protein on cells making them resistant to HIV infection. Only about 10% of people of European or Western Asian ancestry have this inherited mutation. It is even rarer in other populations. 3 years after Timothy received the transplant, he stopped taking his HIV medicines. Researchers continued to test his blood and other body tissue and could not detect any HIV virus. The amount of HIV antibodies in his blood also declined indicating that his body was not even responding to the HIV virus anymore.
For those of you wondering why Doctors do not then just use stem cell transplantation as a standard cure of HIV, this is why. Timothy suffered serious complications from the transplant including damage to his brain and nervous system.
Timothy set up the Timothy Ray Brown Foundation dedicated to fighting HIV. His leukemia eventually recurred and he passed away at the age of 54.
The London Patient
11 years after the case of The Berlin Patient was presented at a medical conference, another patient was also found to be cured of HIV using very much the same treatment. Adam Castillejo aka The London Patient was living with HIV and developed a cancer of his lymphatic system known as Hodgkin’s Lymphoma. Much like The Berlin Patinet, Adam received a bone marrow transplant from a donor who had the CCR5 gene mutation. 3 years after stopping his HIV medications, Adam is still free of HIV.
The Brazilian Man
“Shock and Kill” sounds more like a war strategy than something a Doctor would say. But this was exactly the strategy used to cure a 35 year old Brazilian man. He joined a medical trial and was given an intensive cocktail of HIV killing medicines along with good old Vitamin B3 for 48 weeks which miraculously cured his HIV. He was diagnosed with HIV in 2012 and his HIV was well controlled with standard anti-retroviral medicines. In 2016 he joined the study and as luck would have it, was randomized to receive a new anti-HIV medicine in addition to his usual medicines and also Vitamin B3. Vitamin B3 or Nicotinamide as it is also known, has been used as an anti-infective in the past. The theory was that the Vitamin B3 will kick the HIV that is hiding in reservoirs out of their hiding place. Once out in the open, the aggressive anti-HIV medicines will kill the virus. After being on this special regime for 48 weeks, the Brazilian patient went back to his usual medicines for 3 years. He then decided to participate in yet another trial to stop his medicines and see what happens. For more than a year he was tested every 3 weeks and his tests consistently could not detect any HIV virus. Furthermore, his HIV antibodies fell drastically.
So why do we not just give this treatment regimen to everyone living with HIV? Because unfortunately, out of all the patients who were given this very same treatment, only this one patient was cured. This means that there are multiple factors including his genetics and immune system that contributed to this. Things that we still do not fully understand. But there is hope.
The California Lady and Esperanza Patient
What comes to mind when you hear the words “Elite Controller”? A master at video games perhaps? In HIV medicine, Elite Controllers refer to a very special group of people whose immune systems can control HIV without the need to take anti-retroviral medicines. Although they cannot clear all HIV viruses from their system, the amount of virus in their system is always controlled consequently saving them from most of the negative health effects of a chronic HIV infection. Even without having to take anti-retroviral medicines.
The Esperanza Patient was an Elite Controller. However, her immune system went even one step further. It not only killed HIV outside of its reservoirs but also attacked the reservoirs themselves and killed the virus hiding within. The Esperanza Patient was first diagnosed with HIV in 2013. But since then, conventional tests for HIV virus in her blood consistently came up negative. Not a single test could find any HIV virus in her blood. She even married and had a baby. Her partner and baby are both HIV negative.
Unsatisfied, researchers intensified their search for the HIV virus in her body. They looked at almost the entire genome from 1.2 billion cells taken from her body as well as half a billion cells taken from the placenta of the baby she gave birth to. Her CD4 cells were also tested for latent HIV. And just to be safe, they tested her blood to make sure she was not inadvertently taking any anti-retroviral medicines. What they found was huge chunks of missing DNA where the HIV virus would have been. They also found a total of 7 pieces of HIV DNA that were not capable of making new HIV i.e. dead. This is basically like finding the fossilized bones of a dead dinosaur.
Actually, the Esperanza Patient was not the first person in the world whose immune system managed to clear the HIV infection spontaneously. Another lady in California achieved the same amazing results prior. So far, only these 2 people have experienced this cure. Of course there could be many more such patients out there that have just not been made known to science.
This could be seen as a beautiful proof of Darwinian theory. Where a species will develop changes to its DNA in response to a threat. And while the population with the mutation will survive, the rest of the population will be whittled down. An age old “survival of the fittest” if you will.
In Summary
HIV is still an incurable disease. That said, modern anti-retroviral medicines have made HIV a manageable chronic disease rather than a death sentence it once was. Although there is still no known cure, these cases give us not only hope but avenues for scientific research.
Check out our other articles to learn more about HIV
What are the symptoms of HIV infection?
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