The “HIV cure” – A cure for one person, not for everyone.

“Doctors Claim HIV-Positive Man Cured by Stem Cell Transplant” – Fox News: December 14, 2010

“Stem Cell Transplant cures HIV in ‘Berlin Patient’”- Huffington Post: December 14, 2010

“Evidence for the cure of HIV infection”- Blood: March 10, 2011

Beginning in 2009, rumors suggesting the discovery of a miraculous “cure for HIV” made their way to major news publications and scientific journals throughout the world. The exciting news revolves around Timothy Ray Brown, a forty year old resident of Berlin infected with both HIV and leukemia. Dubbed the “Berlin patient,” Brown received a stem cell transplant in 2007 to treat his leukemia. The cells he received lacked a key piece that HIV needs to infect cells- a molecule called CCR5. The result was astounding: follow up tests could not detect any active HIV in his blood. Over three years later, they still can’t! Finally, after 30 long years the world has found a cure for the treacherous HIV virus that has killed over 25 million people! Right?

Well…not quite. Before calling the Berlin patient’s treatment a cure for HIV, it is important to know that there are two different ways to use the word cure:

Cure (as a verb): To relieve one of the symptoms of a disease or condition
Cure (as a noun): A complete or permanent solution or remedy
These two definitions actually make a difference in understanding what we can say about the Berlin patient. Using the verb form, we can say that the Berlin patient was “cured” of HIV because eliminating of the virus from his body relieved him of the infection. However, I don’t believe we can use the noun form to call stem cell treatment a “cure” for HIV because it is not a permanent solution to the HIV epidemic.

Firstly, the stem cell transplant Timothy Brown received is not simple and in fact, it can be deadly. The procedure involved taking special blood cells from a donor who is resistant to HIV and putting them into his own HIV infected blood. There are many dangers involved with this type of treatment, most notably the risk of transplanted stem cells recognizing the recipient’s body as foreign and attacking it. This process is extremely harmful to the recipient and can be fatal.

In addition to the health risks, there are several factors that make stem cell transplants an impractical cure for HIV. For instance, it is very rare to find donors with blood cells that are resistant to HIV in the first place. To find enough donors who are both resistant to HIV infection and also have matching blood types for the millions of HIV infected individuals is simply unrealistic. On top of that, the cost of stem cell treatment is so expensive that most HIV infected individuals would not be able to afford it. Even if it did cure the Berlin patient, considering all these limitations makes me reluctant to call stem cell treatment “a cure” for HIV.

The reason I am so careful about choosing how to use the word “cure” is because in the context of HIV, finding a cure means so much to over 33 million people infected with the virus today. It would be wrong for scientists to claim a cure for HIV unless it promises to eliminate HIV in a majority of these people. Anything less would be a disappointment for the hopeful individuals who find out this “cure” does not apply to them. In its current state, there are many barriers that prevent stem cell transplants from being a universal treatment and its effectiveness has only been proven in one person- the Berlin patient.

So the next time you hear a shocking headline that claims scientists have discovered “the cure for HIV,” take it with a grain of salt. Read the article and ask yourself: was a cure really found, or have you just read the story of a one man cure? While the Berlin patient is an example of a one man cure, it did have the positive effect of spurring enthusiasm for HIV research. In fact, the National Institutes of Health (NIH) and the American Foundation for AIDS Research (AMFAR) are funding new initiatives to learn information about the Berlin case that may inspire new ways to cure HIV. Hopefully one of these strategies will ultimately work and can be applied universally to help relieve suffering from the infection and eliminate the need for lifelong treatment.

By Angela Hsu

References:

1. Allers, A., Hutter, G., Hofmann, J., Loddenkemper, C., Rieger, K., Thiel, E., Schneider, T. (2010). Evidence for the cure of HIV infection by CCR5Δ32/Δ32 stem cell transplantation. Blood, 117(10), 2791.

2. Cure. (n.d.)and(v.d.)In Merriam Webster online. Retrieved from http://www.merriam-webster.com/dictionary/cure

3. Dieffenbach, C., Fauchi, A. (2011). Thirty years of HIV and AIDS: Future Challenges and Opportunities. Annals of Internal Medicine, 154 (11), 1.

4. Foxnews.com (2010, December 14). Doctors claim HIV-positive man cured by stem cell transplant. Fox News Network. Retrieved from http://www.foxnews.com/health/2010/12/14/doctors-claim-hiv-positive-man-cured-stem-cell-transplant/

5. Hutter, G., Nowak, D., Mossner, M., Ganepola, S., Mubig, A., Allers, K., Schneider, T., Hofmann, J., Kucherer, C., Blau, O., Blau, I., Hofmann, W., Thiel, E. (2011). Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. The New England Journal of Medicine, 360 (7), 693.

6. Jadhav, M. (2000). Blood transfusion associated fatalities. Indian Journal of Medical Sciences, 54 (8), 330-334.

7. Schwarz, C. (2010, December 14). Stem Cell Transplant cure HIV in ‘Berlin Patient’. Huffington Post. Retrieved from http://www.huffingtonpost.com/2010/12/14/hiv-cure-berlin-patient_n_796521.html

August 2011