He’s been called the “Berlin Patient” and the man who was cured of HIV. Today, Timothy Brown is speaking in Houston tonight about the bone marrow transplant from a donor born with resistance to the infection that essentially cured his HIV.
Brown, 45, was diagnosed with HIV in 1995. For more than a decade, he managed the virus with antiretroviral medications while continuing his career as a German-English translator in Berlin.
He was diagnosed with leukaemia in the summer of 2006. Brown was treated with chemotherapy but decided to wait on receiving stem cells from a bone marrow transplant believing it was too dangerous. His oncologist was concerned about the delay, predicting the blood cancer might return. The doctor was right. The leukaemia was back by the end of the year.
Brown underwent a stem cell transplant via bone marrow in February 2007.
“I had a lot of possible donors, but the doctor decided to look for a person that didn’t have the CCR5,” Brown said in a phone interview from San Francisco, where he now resides.
CCR5 is a protein or co-receptor that connects with CD4 cells or primary white blood cells in the immune system. That link is a pathway that allows HIV to cause infection. Without CCR5, a genetic variation, HIV can’t invade the immune system. About 10 percent of Northern Europeans have the mutation.
Brown’s case was documented in a February 2009 issue of The New England Journal of Medicine.
“They found a donor who carried a well-known set of mutations that makes one resistant to HIV,” said Dr. Thomas Giordano, a longtime HIV specialist and medical director of Houston’s Thomas Street Health Center – the Harris County Hospital District‘s HIV/AIDS treatment facility. “Two things are required: CD4, which everyone has, and CCR5, which almost everyone has. If one of them is absent, HIV can’t get in.”
The leukemia returned again and Brown had a second stem cell transplant in 2008 from the same donor.
So, has Brown really beaten HIV?
“He’s cured,” said Giordano, also an associate professor of medicine at Baylor College of Medicine. “I think it’s pretty well accepted that he’s cured. Just like any other chronic illness, you have to reserve a little bit of caution. Could his HIV come back? It’s been theoretically possible, but it’s pretty clear it should have come back by now, but it hasn’t.”
Giordano said the Brown case demonstrates the promise of gene therapy in the fight against HIV/AIDS, but he cautions that Brown is one person in a single experiment.
“A bone marrow transplant, especially from an unrelated donor, is a risky proposition,” Giordano said. “If you have HIV and you are healthy and your viral load is undetectable, your survival is approaching that of someone who does not have HIV. To take the risk of a bone marrow transplant makes no sense at all – unless you have leukemia.”
Even with this advancement, a cure remains “many, many years away,” the doctor added.
“What it has done is quickened the pace of investigation of gene therapies to treat HIV. If you could convert people from having CCR5 to not having CCR5 in some way other than a bone marrow transplant, could you cure people? That’s the avenue that’s being researched now.”
Giordano added that Brown’s case offers hope for people living with HIV/AIDS.
“He is the first person to be cured of HIV. It was an extreme situation and extreme therapy, but it does give you some hope that we can learn enough from him to use a similar genetic approach that would be much safer to slow down, if not cure, the disease or make the need for medication less or something to help people out.”
Brown is speaking from tonight, 23:00 to 02:30 (gmt) (18:00 to 21:30 in Houston) Treebeards, 315 Travis, as part of a limited-seating cure for more information.
Here’s another recent piece about Brown from the Los Angeles Times.
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