Third patient cured of HIV, but little hope for infected millions 

Researchers are getting closer to finding a cure for HIV, after an American patient was recently cleared of the virus. 

And even though the development is going to advance science and is key to a cure, Kenyan researchers have said the treatment cannot be applied to the 1.5 million living with the virus in the country.

This is the third time a patient has ended up in remission from HIV. 

The first to beat the virus that causes Aids was American Timothy Brown in 2007, who had leukaemia, after he received a bone-marrow transplant from a donor with natural immunity to the virus.

Then known as the “Berlin Patient” to protect his identity, Brown was given an aggressive treatment that included two transplants and total body irradiation (radiotherapy) for leukaemia, which is the same treatment the third patient, a middle-aged woman, was given. In 2010, Brown came forward as the Berlin Patient. He died in 2020, a year after the cancer returned.

According to the findings presented at the Conference on Retroviruses and Opportunistic Infections on Tuesday in Denver, Colorado, USA, the patient received bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection.

In 2019, doctors made a second breakthrough with the “London Patient”, later revealed to be Mr Adam Castillejo. He received a bone marrow transplant from a donor, and two years after he stopped taking antiretroviral drugs, highly sensitive tests showed there was no trace of the virus in his body.

Read: First Kenyan to disclose HIV status dies at 63

The third patient’s case was part of a larger study done by researchers from the University of California Los Angeles (UCLA), and Johns Hopkins University in Baltimore. After the results, they aim at following another 25 people with HIV. 

The patient underwent a transplant with stem cells taken from umbilical cord blood. She had chemotherapy sessions that killed her cancerous immune cells. Then she received stem cells from a donor who is resistant to HIV, leading to both her cancer and HIV going into remission.

It is reported that she later developed an immune system that is resistant to HIV.

Prof Omu Anzala, a virologist and a senior clinical researcher at Kenya Aids Vaccine Institute (Kavi) said that as much as the new development is going to advance the search for an HIV cure, there is little hope for the millions who are already infected.

“Even after the first patient was cured, who has since succumbed, nothing much changed. We did not adapt to it as a country. We are just where we were. It is not a walk in the park,” he said.

He elaborated that the technology is advanced and not a viable strategy to cure HIV for most patients living with the virus. It confirms that it is possible to get a cure, yet it cannot apply to everyone, he explained.

“We do not perform the technology in Kenya and it requires additional infrastructure. If we are to perform this, then it is going to be a very expensive procedure which may fail on other patients,” said Prof Anzala, who was not involved in the work.

A procedure in which a patient receives healthy stem cells (blood-forming cells) to replace their own stem cells that have been destroyed by treatment with radiation or high doses of chemotherapy. The healthy stem cells may come from the blood or bone marrow of the patient or from a related or unrelated donor.

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He clarified that for one to get a transplant, the stem cells have to be suppressed and removed, before new ones are inserted. The process, he said, must be done carefully to avoid any infection. Such transplants are highly invasive and risky, so they are generally offered only to patients who also have cancer and who have exhausted all other options.

He emphasised that the only way to finish the virus in our midst is through a vaccine. 

“The truth of the matter is that we need an efficacious vaccine that is affordable to many. This is going to give hope to our people, HIV has not gone away. We must avoid new infections by all means,” he said.

“A world with a HIV vaccine will be healthier to live in,” Prof Anzala.

The quest for the HIV vaccine started four decades ago.

Less than a week ago, International Aids Vaccine Initiative and Moderna announced that they would be conducting in-human HIV vaccine clinical trials using messenger RNA (mRNA) technology. The study is being conducted in the United States, where 56 HIV negative individuals will be vaccinated in a first of its kind treatment.

“Using mRNA for vaccines allows for faster production of vaccine material. With conventional approaches, it can take years to advance a promising idea in the lab into a vaccine candidate that can be evaluated in humans. It can reduce that time from several years to several months,” explained Dr Muturi-Kioi of the International Aids Vaccine Initiative (Iavi), who is based in Kenya.