Munich, Germany — The world eagerly awaits the day when we can announce a cure for HIV. Reports now indicate that this day may be near. Several individuals have been cured of HIV around the world, which raises several questions.
HIV attacks the body's immune system and if not treated, it can cause AIDS. Decades ago, HIV patients were expected to die since there was no cure, no vaccine, and few treatments
What does it mean to be cured of HIV? To achieve a cure, what steps must be taken? What are the risks involved for people living with HIV who attempt a cure?
Timothy Ray Brown, the "Berlin patient," beat HIV using a stem cell transplant, a procedure only recommended for patients with a certain type of leukemia not responding to chemotherapy. He was announced as cured in 2008. Brown was followed by Adam Castillejo, the "London patient" who had Hodgkin lymphoma and was also announced cured, in 2019. Two other people are considered "possibly" cured.
The Düsseldorf Patient
At the 25th International AIDS Conference in Munich, we met Marc Franke, the 55-year-old from Germany known as the "Düsseldorf Patient". Franke, who once had HIV and leukemia, shared his inspiring journey of overcoming both illnesses. His story, filled with optimism, called for the importance of scientific collaboration and the support of loved ones.
"I hope scientists come together, find the right puzzle pieces, and put them together to find a cure for everyone," he said.
Franke was diagnosed with HIV in 2008 and started treatment in 2010. His health declined again in 2011, and he suspected he had pneumonia. He later learned he had acute myeloid leukemia (AML).
After undergoing chemotherapy, Franke went into remission and then relapsed. A stem cell transplant became his only viable solution.
For Franke's stem cell transplant, his doctors sought a donor to recreate the success of the "Berlin patient".
"... so they searched for possible donors, and in these donors, they searched for the one with the gene mutation they called the CCR5-Delta 32 receptor." The receptor is instrumental in curing HIV in some patients. Timothy Ray Brown, the "Berlin patient", was the first known HIV patient to be cured after extensive treatment. Adam Castillejo, the "London patient" followed, and two others are "potentially" cured. Franke recalled watching a documentary about Timothy Ray Brown: "When I saw the documentary while waiting for the transplant, I thought, well, if it worked once, why shouldn't it work twice? I was optimistic."
To help Franke, the doctors identified one person with the mutation - Anja Prause, a former flight attendant. As a carrier of the gene mutation CCR5-Delta, Prause is essentially immune to HIV, since the virus is prevented from docking on immune cells. In 2013, Franke underwent a bone marrow transplant using Prause's bone marrow to cure him of HIV.
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A stem cell transplant can present significant challenges, but it can also offer hope, according to Franke's doctor at Düsseldorf University Hospital, Dr. Björn Jensen. "Timothy Ray Brown and Adam Castillejo's success stories demonstrate that, with the right conditions, we can achieve long-term remissions and potential cures. Future research aims to build on these successes, exploring gene editing, therapeutic vaccines, and other innovative approaches to achieve a more universally applicable cure," Jensen said.
In 2018, under medical supervision, Franke stopped taking antiretroviral therapy (ART).
"We started with an HIV test two times a week, later one time a week, then every two weeks, monthly, and now we are at every two months," he said. "Now I have 100% confidence that the HIV is gone."
Franke called for the importance of fighting against HIV stigma and making testing more accessible. "Fight against HIV stigma, make HIV tests easily, inexpensively, available anonymously. Know your status, and tell everyone about U = U and PrEP. This is a real game changer."
He also stressed the need for a broader understanding of who HIV affects: "Make people realize that HIV does not only affect MSM (Men who have sex with men), over 50% of positive people worldwide are women. Continue your search for a cure. And I want researchers to connect worldwide."
