Human Immunodeficiency Virus (HIV) is one of the major world health issues. It was believed to have originated in non-human primates in West-Central Africa and transferred to humans in the early 20th century. HIV is a blood-borne virus that damages immune system. Over time, it causes acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.
According to World Health Organisation (WHO) and Global Health Observatory (GHO) data, 75 million people have been infected with HIV virus and about 32 million people have died of HIV. The WHO African region remains most severely affected, with nearly 1 in every 25 adults (3.9%) living with HIV and accounting for more than two-thirds of the people living with HIV worldwide.
Although a cure for HIV does not yet exist, people living with HIV can be managed with anti-retroviral therapy. This is recommended for all people living with HIV, regardless of how long they have had the virus or how healthy they are.
The first breakthrough in finding a cure to HIV was recorded in 2007 when team of doctors were treating leukemia. At the Conference on Retroviruses and Opportunistic Infections in 2008, an American, Timothy Ray Brown was announced to be the first person to have been cured of HIV/AIDS. Brown’s HIV advocacy journey began in 1995, the year he was diagnosed. At the time, Brown thought it was a death sentence. And in a one-two punch, he was diagnosed with leukemia a few years later. In 2007, Brown underwent a procedure known as hematopoietic stem cell transplantation to treat leukemia.
Stem cell transplant, sometimes called a bone marrow transplant is a treatment for some types of cancer of the blood or bone marrow, such as multiple myeloma or leukemia. It is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood. This procedure was performed on Brown in 2007. A year later, it was repeated after a leukemia relapse. In 2008, doctors could not detect HIV in Brown’s blood and in various biopsies and hence, the first cure was announced.
The second HIV cure was announced this year, a year after it was first announced in London. The story of Adam Castillejo, a 40-year-old cancer patient is similar to that of Brown that was cured in Berlin. Castillejo is found to be free of HIV more than 30 months after stopping anti-retroviral therapy. According to the Lancet HIV journal report, Adam was not cured by the HIV drugs, however, but by a stem-cell treatment he received for a cancer he also had. Michel Sidibé, Executive Director of UNAIDS said:
“To find a cure for HIV is the ultimate dream. Although this breakthrough is complicated and much more work is needed, it gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure. However, it also shows how far away we are from that point and of the absolute importance of continuing to focus HIV prevention and treatment efforts.”
In another development, researchers have been able to successfully eliminate HIV from the DNA of infected mice for the first time, bringing them one step closer to curing the virus in humans.
Researchers at Temple University in Philadelphia and the University of Nebraska say they have come up with a revolutionary gene-editing tool. The team injected mice with human bone barrow to mimic the immune system and were able to eliminate HIV in nine of the 21 animals. Senior investigator Professor Kamel Khalili, an AIDS expert at Temple University, said:
“Our study shows treatment to suppress HIV replication and gene editing therapy, when given sequentially, can eliminate HIV from cells and organs of infected animals.”
Looking at the complexity, cost, side effects and other factors, stem cell transplants are not feasible way of treating large numbers of people living with HIV. However, the results do offer a greater insight for researchers working on HIV cure strategies and highlight the continuing importance of investing in scientific research and innovation.
In 2012, US authorities approved the development of pre-exposure prophylaxis (Prep) which is one of the most exciting breakthroughs in recent years. Prep has been shown to lower the chance of a person becoming infected with HIV during sex by more than 90 per cent when medication is taken daily. It can reduce the risk of contracting HIV from needle use by roughly 70 percent.
It is important to know that while the Berlin and London patients are the only people known to have been “cured” of the disease, today patients can be functionally cured – that is, the level of virus in their blood is so low that it is undetectable and they cannot pass it on.
HIV is not a death sentence, get tested, know your status and save your love ones. With proper treatment, people with HIV can live long and have healthy lives.
You will learn more about how to protect yourself and your partners and get information tailored to meet your needs in one of our subsequent articles.
Gulland, A. and Newey, S. (2019). From ignorance to a potential cure: the history of HIV breakthroughs. Retrieved on 20th March, 2020 from https://www.telegraph.co.uk