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    A Cure for HIV?

    HIV Cured in Berlin Patient -- What It Means

    How was the Berlin patient cured of HIV? continued...

    The patient's doctor, Gero Hütter, MD, had an idea. Since HIV hides in white blood cells, why not try to cure the patient of leukemia and HIV at the same time? Instead of a normal donor, Huetter looked for a donor who carried the relatively rare mutation called CCR5delta32.

    People with this mutation lack functional CCR5, the keyhole that HIV most often uses to enter cells. People who inherit two copies of this gene are highly resistant to HIV infection. So Hütter found a stem-cell donor who carried this mutation and used the cells to repopulate his patient's immune system.

    During his recovery from the harsh conditioning treatment, the Berlin patient wasn't able to keep taking his HIV drugs. His HIV viral load shot up. But after receiving the HIV-resistant stem cells, his HIV dropped to undetectable levels -- and remained undetectable, even with extremely sensitive tests.

    A year later, the patient's leukemia came back. He underwent a second round of chemotherapy and a second infusion of the HIV-resistant stem cells. It wasn't an easy treatment. The patient suffered intestinal and neurological symptoms, during which time biopsies were taken of various organs.

    All of the tissues tested negative for HIV. "That was curious," says John Zaia, MD, chair and professor of virology at City of Hope, Duarte, Calif. Zaia has worked for more than a decade on developing stem-cell treatments for HIV and AIDS and has personally reviewed the Berlin patient's case with Hütter.

    "There has been nobody who ever went off their anti-HIV medications without their HIV coming back," Zaia tells WebMD. "But this patient is still off treatment three and a half years later. Dr. Hütter is using the word 'cure' [in his new paper] for the first time. It is remarkable."

    The Berlin patient's HIV remains totally undetectable. Moreover, his anti-HIV antibody levels continue to decline, which would not happen if there were still HIV present to stimulate antibody production. That's what led Hütter and colleagues to deem him cured.

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