No Trace of HIV After Stem-Cell Transplants, Researchers Say07/03/13
WEDNESDAY, July 2 (HealthDay News) -- Two HIV-positive patients
show no trace of virus after receiving chemotherapy and stem-cell
transplants as treatment for lymphoma, according to new
These patients have become the second and third known cases of a
"sterilizing cure," in which medical treatment removes all traces
of HIV -- the virus that causes AIDS -- from the body. They have
remained virus-free even though doctors months ago took them off
their HIV-targeted medications.
"We have been unable to detect virus in either the blood cells or the plasma of these patients," said lead researcher Dr. Timothy Henrich, of Harvard Medical School and Brigham and Women's Hospital in Boston. "We also biopsied gut tissue from one of our patients, and we were unable to detect HIV in the cells of the gut. Essentially, we do not have any evidence of viral rebound."
The findings are scheduled for presentation Wednesday at the
International AIDS Society Conference in Kuala Lumpur,
The patients had been receiving long-term antiretroviral therapy
for HIV when they developed lymphoma, a type of blood cancer
involving white blood cells, Henrich said.
Both underwent chemotherapy followed by bone marrow transplants
to cure their lymphoma. Afterward, Henrich could not detect any HIV
infection in their bodies.
Henrich presented preliminary findings on the research at the
International AIDS Conference last July. Since then, he and his
research team withdrew the patients' antiretroviral therapy to see
how completely the cancer treatment had rid them of HIV. One
patient has been off treatment with no detectable virus for about
15 weeks, and the second patient for seven weeks.
Henrich warned that it is too soon to declare the patients
completely cured of HIV. "Although we cannot detect HIV, it's
possible it's there but in extremely low amounts," he said. "We're
going to watch and wait, and see where it goes with these
Unfortunately, this type of cure is not something that can be
put into widespread practice for all people infected with HIV.
"Transplantation is not a scalable, affordable or even safe
treatment for HIV patients," Henrich said.
The so-called "Berlin patient," Timothy Brown, is the first
documented case of a sterilizing cure for HIV. An American man
living in Germany who received a bone marrow transplant for
leukemia, Brown has remained HIV-free even after discontinuing his
antiretroviral drug therapy. The transplanted bone marrow cells
came from a donor who had a rare genetic mutation that increases
immunity against the most common form of HIV, and researchers
believe that helped protect Brown from re-infection.
In Mississippi, a baby born with HIV nearly three years ago is
the first case of a "functional cure," in which early treatment
eradicates the virus. Immediate treatment with antiretroviral
medications rid the child of all traces of HIV within the first
month of life, and she has remained virus-free even after
discontinuing drug therapy at 18 months of age.
Henrich's findings are significant because his two patients did
not receive bone marrow cells with the genetic mutation that helped
Brown. They also did not receive the intensive chemotherapy or
total body irradiation that preceded Brown's stem-cell
Instead, their stem-cell transplants appear to have been
protected by the patients' ongoing antiretroviral therapy, which
continued as they received cancer treatment.
"In bone marrow transplants, the donor cells actually eliminate and replace the host patient's blood cells," Henrich said. "Antiretroviral therapy allowed the donor cells to replace the host cells without becoming infected."
By comparing Brown with the two new patients, researchers hope
to better understand the immune responses that have protected all
three, said Rowena Johnston, vice president and director of
research for amfAR, the Foundation for AIDS Research, which is
funding Henrich's research.
"It was quite unclear at the time how that cure came about," Johnston said of the Brown case. "One way these Henrich findings are significant is that they allowed us to tease apart those factors that may have been key to curing Timothy Brown."
Together, the three patients can tell researchers a lot about
the barriers to a cure and how they might be overcome, Johnston
Perhaps some day the treatment that helped these patients will
be available to everyone with HIV, she added.
"We currently imagine that curing people on a large scale through stem-cell transplantation would pose many daunting challenges, but gene therapy researchers are working on ways this might one day be possible," Johnston said.
Findings presented at meetings should be considered preliminary
until published in a peer-reviewed medical journal.
For more information on HIV cures under investigation, visit
amfAR, the Foundation for AIDS Research.
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