Can we cure an HIV positive patient?

London patient: Probably second cure for HIV

In March 2020, almost three years after stopping his HIV medication, Adam Castillejo was no longer able to detect HIV. Thanks to a stem cell donation as part of a cancer treatment, he is considered the second person to be cured of HIV. The procedure is only possible in exceptional cases - the highly effective HIV treatment, on the other hand, for all people with HIV.

The Reuters news agency had already reported in March 2019 that the HIV-positive man called the "London patient" was HIV-free, although he had discontinued his HIV medication in October 2017.

London patient: HIV cure through stem cell transplantation

Adam Castillejo grew up in Caracas (Venezuela) and has lived in London since 2002. In 2003, at the age of 23, he was diagnosed with HIV.

In 2011 he was also diagnosed with cancer (stage 4 malignant lymphoma) and started chemotherapy. In 2014 he felt so bad that he thought about suicide, and in the spring of 2015 his doctors told him that he would not live to see Christmas again.

A friend of Castillejo's found a doctor who had experience with cancer treatment and bone marrow transplants.

As in the first case of an HIV cure in 2007 - Timothy Ray Brown went down in history as the “Berlin patient” - this doctor found a stem cell donor with a rare genetic mutation that protects him from most forms of HIV.

The health of the "London patient" was loud New York Times before the transplant better than Timothy Ray Brown's. Also, his immune system wasn't shut down as much as Brown, so the operation wasn't quite as dangerous.

After the transplant, however, Castillejo lost a good 30 kilograms, contracted several infections and had to undergo multiple operations. His mouth was so infected that he could barely swallow his HIV medication.

Today the 40-year-old is better again, according to the New York Times in a report.

Castillejo sees himself as an “ambassador of hope” and also runs the Twitter account Londonpatient_Hope (@londonpatient).

HIV is now easily treatable

Another case of a possible HIV cure from Düsseldorf was reported in 2019. This patient also had cancer and was treated with the same method as Timothy Ray Brown and Adam Castillejo.

In March 2020, scientists from the University Hospital Düsseldorf reported that even 15 months after discontinuing HIV therapy, there was no evidence of HIV multiplication.

Even if three success stories already show that HIV is in principle curable: a stem cell transplant remains a method for exceptional cases. The risky procedure is only used when it is urgently needed. Worldwide, a total of 38 patients with HIV were observed after such an operation in 2019.

Modern HIV drugs, on the other hand, are suitable for all people with HIV. Although they do not remove the viruses from the body, they permanently suppress virus replication.

With early diagnosis and early start of treatment, they offer a good chance of a normal long life without major physical discomfort and also prevent the transmission of HIV.

(hs)

Report in the New York Times of March 9, 2020 (accessible after registration; in English)

Report on queerty.com of March 10, 2020 (in English)

Scientific article in The Lancet HIV on March 10, 2020 (free access; in English)

Information on the London and Düsseldorf patient (in English)

Detailed information on the London patient

More information on both cases (New Scientist)

Scientific details on the London patient on nature.com

Report of the Rheinische Post on the Düsseldorf patient

"My HIV cure has changed everything" (contribution to the "Berlin patient" on magazin.hiv)