Timothy Ray Brown Appears to be First Person “Cured”

Photo: Timothy Ray Brown is nicknamedthe “Berlin Patient

By James Michaels

BERLIN, GERMANY – This June 5th will be the 30th anniversary of the disease we now call AIDS. It was on that date that the Centers for Disease Control in Atlanta reported an unusual case of five gay Los Angeles men who were suffering from a strange form of pneumonia. Because of the connection with the gay men, the disease was originally referred to as GRIDS (Gay-Related Immune Deficiency Syndrome).

At first, being diagnosed with AIDS was the equivalent of an immediate death sentence; however, through the last three decades various drugs and drug combinations (often referred to “drug cocktails”) allowed people living with the HIV/AIDS virus to lead a long and fruitful life, with the virus almost undetectable, as long as the patient continued to take the drugs. An actual “cure” for AIDS, however, has been elusive. Scientists have been studying immunity to HIV since the disease was discovered 30 years ago, as it soon became apparent that a small percentage of people seemed to be naturally resistant.

Now, after 30 years comes word of a patient who appears to be the first person in the world to have actually been cured of the disease. Nicknamed the “Berlin Patient,” he is Timothy Ray Brown, 45, originally from Seattle and currently lives in the San Francisco area. He first tested positive for HIV in 1995. Doctors believe they cured Brown’s HIV infection via a stem cell transplant that contained cells that were impervious to the HIV infection. While living in Berlin, Brown received a stem cell transplant back in 2007 as a treatment for his leukemia. Before the transplant, he received chemotherapy treat eradicated most of his immune cells, and received further immunosuppressive drugs to prevent his body from rejecting the stem cells.

But these were no ordinary stem cells – a mutation found in just one percent of Caucasians in Northern and Western Europe causes CD4 cells to lack the CCR5 receptor, a receptor necessary for earlystage HIV to infect CD4 immune system cells. (People with this mutation are more immune to HIV infection.) Scientists believe the mutation arose in the Middle Ages; some experts have suggested it spread in response to the Black Plague, while others have pointed to smallpox as more likely. Survivors of that era developed a genetic mutation which has been passed down to their heirs called a “CCR5 delta-32 deletion”. Scientists believe those who have one copy of the CCR5 gene enjoy some resistance against HIV, but not total immunity. That seems to be the case in about 10 to 15 per cent of those descended from Northern Europeans. Those who inherit two copies of this so-called “immune gene,” one from each parent, seem to have strong immunity to HIV. That’s the case in an estimated 1 per cent of people descended from Northern Europeans, with Swedes being the most likely candidates. It means today, if both of your parents have this mutation, your body lacks the “doorway” for HIV to enter. Brown says that he quit taking his HIV medication the day that he got the transplant and hasn’t had to take any since.

Through the years since the transplant, Brown’s progress had been reported in medical journals and other media outlets. The Wall Street Journal first reported the story on November 7, 2008, declaring that the patient “appears to have won the battle with AIDS”. The following month, the New York Times wrote, “the man has been free of the virus for 20 months”. Last December, the patient’s doctors reported in the peer-reviewed medical journal, Blood, that tests “strongly suggest that the cure of HIV has been achieved in this patient.”

The various reports referred to the patient simply as the “Berlin Patient” and Brown’s personal identity had not been known until Brown himself made the revelation, claiming “I’m cured of HIV. I had HIV but I don’t anymore.”

Brown is being studied closely by AIDS researchers in Northern California, where he now lives. Their goal is to try to replicate Brown’s reported success in other patients. As difficult as that might be, he represents new hope for an outright cure that wasn’t there before. Brown’s story does have some setbacks.

Brown suffered some neurological problems that affected his motor skills; however, he is improving. Also, the same procedure had been previously tried on other patients who did not survive.

Researchers warn that while Brown’s recovery is indisputable, it by no means indicates that a cure for AIDS has been discovered. The findings, however, open the door for further review and optimism in the frustrating battle that has raged against HIV/AIDS for three decades.

There are a number of hurdles. For one thing, some experts have cautioned that HIV could still be lurking somewhere in Brown’s body and are referring to Brown’s treatment as being more of a “functional cure”.

There’s also the risk – and difficulty – of doing stem cell transplants, and the relative paucity of donors. Donating stem cells is a bit more invasive than a standard blood donation, and finding a good fit between donors and recipients isn’t easy.

AIDS pioneer scientist, Dr. Paul Volberding, cautioned, “The Berlin Patient is a fascinating story; it’s not one that can be generalized. You don’t want to go out and get a bone marrow transplant and the bone marrow transplants themselves carry a real risk of mortality.” But Volberding added, “He [Brown] hasn’t had a recurrence now for several years of the virus and that hasn’t happened before in our experience.”