The Herald (Harare)

2 August 2012

Zimbabwe: Meet HIV Cure Miracle Man

For the past three decades, people living with HIV, researchers and scientists have been frantically looking for the cure or vaccine of HIV. The virus, which causes Aids, has caused millions of deaths worldwide and today 30 million people are living with it.

Now, the indefatigable efforts, hopes and prayers can as well have found the answer.

A US man, Timothy Ray Brown, has become the first to celebrate victory over HIV as he was cured of the disease in February 2007.

Indeed, he is one lucky chap who has lived to share his story and bring hope to many others.

Speaking to The Herald on the sidelines of the just-ended XIX International Aids Conference in Washington, DC, Brown, aged 47 from San Francisco, said he was just an ordinary interpreter when he discovered that he was HIV positive in 2006 just days after also learning he had leukemia.

Today, he has turned celebrity as many people want to hear his story.

"I suffered fatigue and a friend told me to visit a doctor since I was seriously ill. I was diagnosed with anaemia and was taken to a doctor who diagnosed leukemia.

"Things moved so fast and I was in hospital getting chemotherapy the next day.

"My doctor tested my blood to enable him find a donor for a stem cell transplant. I was lucky as he found out that I had many prospective donors.

"My friend also had leukemia but the operation did not work and he died. This gave my doctor the idea of looking for a donor who was CCR5 negative," Brown narrated.

CCR5 is a protein that sits on the CD4 T cells and it acts as a door for the virus to get into the cell. If it is not there then the virus has no way to enter the cell.

Luckily, Brown found a donor who was CCR5 negative and did not have HIV and was essentially immune.

"When I had the transplant in February 2007, I took over my donor's immune system, so I am not me anymore.

"Within three months after the transplant, I discovered that I was free of HIV," he said.

While many would immediately celebrate and tell the world the good news, Brown kept a low profile only coming out after a doctor shared his story with some people.

"I came out of hiding at the end of 2010 and have been going around the country sharing my story.

"I lay low because I was recovering from all the operations and did not feel that I would do things I am doing now.

"I also realised that I could not just sit around and be the only man cured of HIV. I want to help others," he added.

Sadly, his leukemia came back and has been bugging him.

He believes HIV can soon be history as he is living proof that the disease can be defeated.

"A cure is possible, I am a pure concept. It was after my treatment that people have started talking about a cure.

"My being cured is giving people hope. Medical science will be able to come out with a cure," he added.

Brown said he does not eat meat but likes sea food and fish, vegetables.

He said his family was very supportive during his trials and tribulations.

"When I found out about HIV I did not tell my mother because she was dealing with breast cancer. I later told her and she was very supportive.

"She was the first person I thanked because she used the little money she had to visit me while I was very ill," he added.

Even if he has been HIV free for five years, Brown continues to go for several tests with the results coming out negative.

"I have been tested and tested and they even took a lymph node off my groin and it still carried negative results," he said.

Brown said his goal now is to get funding to sponsor and pay for an HIV cure and vaccine research.

"I believe that it can be done because I am proof of concept.

"I have high hopes that they will be able to find a cure soon," said Brown.

He added that economic powerhouses should invest more in finding a cure or vaccine for HIV and save thousands from dying.

"The biotech industry in the US is heavily under-funded. China invested US$300 billion for the next three years while the US only invested US$2 billion in the entire biotech industry.

"That needs to change. I believe a cure for HIV will come out of the bio industry hence the need to properly fund it worldwide.

"It is very difficult to say whether the cure will come from the US, Europe or Africa. I do not know but I want a cure," he pointed out.

Added Brown: "I am the only person in the world cured of HIV and I do not want to continue saying I am cured. I want to say we are cured. I hope it will be a possibility in the near future."

Scientists say people who have one copy of the CCR5 gene enjoy some resistance against HIV, but not total immunity.

This looks like the case in about 10 to 15 per- cent of those descended from Northern Europeans.

Vice-chairperson of Research in the Department of Pathology at Miller School of Medicine, University of Miami, Professor David Watkins confirmed that it is possible that Brown was cured after the bone marrow transplant.

But is this the future cure for HIV?

Prof Watkins said it is unlikely that the bone marrow transplant would be used to cure HIV.

"A bone marrow transplant has a high level of mortality, about 30 percent.

"When you get a transplant, your own cells have to be killed and bone marrow destroyed to remove any existing leukemia cells.

"When you do that you become very susceptible to infections because you have no immune system for protection since your bone marrow cells provide the protection against infections.

"If a person acquires an infection during the procedure that infection can kill him or her," he added.

He also said the bone marrow transplant is a non-starter for poor communities as the procedure is also very expensive.

One has to fork out about US$350 000 to have the transplant done.

Thirdly, he said, it will not be possible to receive medical approval to do a bone marrow transplant for an individual just to cure HIV.

"You will be doing harm to a patient when there is another course of treatment in this case ARVs to treat HIV infections.

"No clinical ethics will allow a doctor to put the person at risk by doing a bone marrow transplant.

"We have to come up with other ways to remove the door handle off the CCR5 cells other than through doing the bone marrow transplant.

"The ways that are being explored are using things like HIV as a delivery device to introduce mutant versions of the CCR5 gene into an individual's bone marrow," he revealed.

Added Prof Watkins: "You would not do a bone marrow transplant but take the individuals own bone marrow and introduce the defective CCR5 gene using HIV as the vector, using the infectious capacity of HIV. "You would not use an entire HIV but one that has had its pathogenic determinants removed."

This, he said, would allow them to use the part of genetic therapy and get rid of the identified parts thereby rendering an infected person resistant to HIV.

"Timothy Brown is the living evidence that the process can theoretically work if we can remove those door handles so that the virus has nowhere else to go and eventually die off.

"We would also like try to achieve that through anti-retroviral therapy by using more intensive regiments of HIV to try and get the virus to non existence," he added.

Prof Watkins said while research for a vaccine and cure is taking place, it is important for those already infected to religiously take their medicine.

"We all know that ART works and keeps patients essentially disease free for decades but if an individual stops taking therapy within a couple of weeks the virus returns," he added.

He pointed out that for all the years that the virus has been undetectable in the blood, it has been hiding somewhere in the body and this is the biggest challenge facing the HIV research field.

"The cure field is finding out where the virus is hiding and flushing out the hiding places so that we can attack it with ARVs.

"My lab is heavily involved in that kind of research. We think we found one of the hiding places which is the lymph nodes and intestines as they have a lot of T Cells, the major cells HIV infects.

"Most of these T cells in the body are in lymph nodes tissue and intestine lining," said Prof Watkins, who was recently awarded a US$10 million grant to develop an HIV vaccine. In blood it works fine, the drugs are there and penetrating the blood cells, but in tissue, it looks like a different story.

"If that's the case, then we need to come out with drugs to penetrate the hiding places of the virus more effectively and maybe that would accelerate the decline of the virus to zero," he added.

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