10/25/2014

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HIV-cured patients may offer answers to local doctors

SEATTLE -- Local researchers are studying two Boston men who may have been cured of HIV to see if their cases contain lessons that could help other HIV patients.

In 2009, Timothy Ray Brown became the first person reportedly cured of HIV after he underwent a bone marrow transplant to treat leukemia. His marrow donor carried a genetic mutation that made the donor cells resistant to HIV. To date, doctors have not been able to detect any of the HIV virus in Brown's body.

Now, Harvard University researchers have announced two HIV-positive patients in Boston who underwent bone marrow transplants for cancer may also be cured. The men stopped anti-retroviral therapy and still show no detectable sign of the HIV virus.

Researchers at Fred Hutchinson Cancer Research Center have been watching the progress of others in their field and believe cases like those in Boston might offer information on treatments that could cure HIV positive patients who don't have blood cancers.

Doctors at Fred Hutch and around the world are performing bone marrow transplants on patients with blood cancers who are also HIV positive, but none of their patients have been taken off antiretroviral drugs.

"It is possible there are others cured out there," said Dr. Hans-Peter Kiem, a member of the Clinical Research Division at Fred Hutch.

Still, Kiem said a bone marrow transplant would not be a reasonable therapy option for HIV-positive patients who do not have blood cancer because the procedure is so dangerous.

"Even with the reduced intensity transplant protocol it is still fairly risky," Kiem said. "The patient can become very sick or die."

Since Brown was declared cured, Kiem said Fred Hutch has received funding to investigate exactly how the transplant eradicated his virus. He hopes to analyze the Boston cases in the same way.

"This therapy is not applicable to many patients, but it opens up another area of research," Kiem said. "How can we use this information to engineer immune cells to achieve exactly what the Boston group has done in a less risky procedure?"

Kiem is currently researching HIV positive patients might be cured by manipulating their own bone marrow in a lab and then injecting it back into the patient.

He said the Boston patients will likely inspire more researchers to focus on finding a cure for HIV.

"Thinking about a cure was on the backburner for many years because patients were doing fine on the antiretrovirals," Kiem said. "These patients have launched new direction so we are getting closer to a cure."

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