We have the cure for HIV since 2008. Now an umbilical cord can take us to the next level

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In 2006, 11 years after a Berlin doctor diagnosed him with HIV infection, Timothy Brown felt tired. Unusually tired. In the hospital, his doctors identified an anemia, first; and a leukemia, later. He started chemotherapy and although he started doing well, his therapists started looking into a possible bone marrow transplant.

A lucky break. It was then that Gero Hütter, from the Charité hospital in Berlin, found the perfect donor. Not only did he have a good biocompatibility profile, but he had a mutation in the gene for a receptor, called CCR5, that HIV uses as a hook to sneak into lymphocytes, the immune cells it infects. It was something extremely rare because only 1% of the population in northern Europe has this mutation and, thanks to it, is resistant to HIV. Hütter saw the opportunity to do a two-for-one: not only cure leukemia, but also make it resistant to the virus.

In the first moment, Brown ruled it out. By that time, antiretrovirals had already turned HIV into a chronic disease and he believed that he did not need to risk his life in a transplant that could end his life. However, when all other cancer treatments failed, transplantation became the last option. And it was hugely successful. For the next 12 years (Brown died in 2019 from cancer), HIV did not reappear in his system: he was the first person “cured” of the infection.

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A very risky treatment. Despite the excitement and expectations that aroused that case, it was a really delicate treatment. To get an idea: it consists of destroying the patient’s immune system and ‘introducing’ another person’s immune system with all the dangers that a transplant (and its rejections) entails. In other words, medical logic restricted this approach to people who had to undergo a transplant like this because it was already their last resort against cancer. In the end, between 40 and 50% of patients with HIV who receive the transplant, die.

To that, we must add that the process is not scalable either. As I said, there are not many cases of people resistant to the virus. It was very difficult to find this type of donor because, as if that were not enough, those who appeared had to be ‘potentially’ compatible with the patient. And, despite everything, the machinery of the medical system was put into operation and a series of transplants that resulted in failure. In fact, despite the progress, there was only one other case that could be considered a success.

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a new technique. And I say ‘there was’ because now they just went public the results of a transplant different from the previous ones. While the two successful patients underwent bone marrow transplantation from adult donors fully compatible with their immunological profiles, umbilical cord blood from a donor who also had the CCR5 gene mutation was used in the case of the current patient. It looks very similar, but this allows for much less profile support.

Success… for now. Doctors withdrew the patient’s antiviral treatment 37 months after the transplant. As far as we know now, a year and two months later, shows no trace of HIV in blood or antibodies against the virus. It is, as they say in jargon to avoid talking about ‘cure’, a new case ‘in remission’. The calculations of the team that has carried out the research say that up to 50 people a year could benefit from the new technique.

Undoubtedly, we are a long way from finding a cure for HIV infection; but it is hopeful to see how, despite the innumerable difficulties, we are making little progress in the face of a disease that has lost media attention, but not its impact on the lives of millions of people.

In 2006, 11 years after a Berlin doctor diagnosed him with HIV infection, Timothy Brown felt tired. Unusually tired. In…

In 2006, 11 years after a Berlin doctor diagnosed him with HIV infection, Timothy Brown felt tired. Unusually tired. In…

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