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How Did the 'Berlin Patient' Rid Himself of HIV?

Posted by Soulskill on from the patent-pending dept.

sciencehabit writes: Researchers are closer to unraveling the mystery of how Timothy Ray Brown, the only human cured of HIV, defeated the virus, according to a new study. Although the work doesn't provide a definitive answer, it rules out one possible explanation. [R]esearchers point to three different factors that could independently or in combination have rid Brown’s body of HIV. The first is the process of conditioning, in which doctors destroyed Brown’s own immune system with chemotherapy and whole body irradiation to prepare him for his bone marrow transplant. His oncologist, Gero Hütter, who was then with the Free University of Berlin, also took an extra step that he thought might not only cure the leukemia but also help rid Brown’s body of HIV. He found a bone marrow donor who had a rare mutation in a gene that cripples a key receptor on white blood cells the virus uses to establish an infection. (For years, researchers referred to Brown as "the Berlin patient.") The third possibility is his new immune system attacked remnants of his old one that held HIV-infected cells, a process known as graft versus host disease.

22 of 107 comments (clear)

  1. Missing in the Summary by Anonymous Coward · · Score: 2, Interesting

    Although the work doesn't provide a definitive answer, it rules out one possible explanation

    ...that conditioning by itself likely cannot rid the body of the AIDS virus.

    1. Re:Missing in the Summary by ArmoredDragon · · Score: 4, Interesting

      IMO he probably still has traces of the virus within his body somewhere, but in such small quantities that it's undetectable. Other viruses are known to do this, such as chickenpox, which can resurface later in the form of shingles if the immune system ever weakens. Except HIV feeds off of the immune system itself, so it's likely he'll never see symptoms of it again.

      However it would be unwise for him to do whatever he did to contract it in the first place as he could either spread his to somebody else or contract another variation of the disease that doesn't rely on the same receptor that he is now immune to (and yes, he does fit the "risk category" demographic if you haven't read his history.)

    2. Re:Missing in the Summary by jae471 · · Score: 3, Informative

      OP said "AIDS virus", not AIDS. HIV is the virus that causes AIDS. Calling HIV the AIDS virus is no different than calling rhinovirus the "common cold virus".

      (Unless you're one of those people...)

    3. Re:Missing in the Summary by rasmusbr · · Score: 2

      Little known fact: a person with HIV who has access to the right retroviral drugs and takes them on time is practically unable to transmit HIV during sex. There are now anecdotes about HIV positive men who have had sex without using a condom with hundreds of non-HIV positive men without a single instance of transmitting the virus.

      Of course, these people still transmit other STD:s.

    4. Re:Missing in the Summary by TangoMargarine · · Score: 2, Insightful

      Good for them, I guess? Still nothing I would ever want to validate experimentally...

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    5. Re:Missing in the Summary by Anonymous Coward · · Score: 5, Insightful

      Call me old fashioned, but if you know you're HIV+, and have unprotected sex with hundreds of people ... you're an asshole.

      I find it hard to believe all of those people have had the benefit of informed consent.

      And, for what it's worth, yes, I do know people who are HIV+, and yes, they're gay men.

      Stuff like this is what people have been trying to combat.

    6. Re:Missing in the Summary by Gavrielkay · · Score: 3, Informative

      Actually, if what I remember is correct, people with that mutation mentioned are unable to get AIDS. Their T-cells lack the receptor that the virus attaches to. This was discovered a while back when certain people never got AIDS despite engaging in all the same risky behavior that caused people around them to get sick in droves. Apparently the mutation was enriched in Europeans because it also provided protection against the plague.

    7. Re:Missing in the Summary by rogoshen1 · · Score: 2

      i think you should be a 'felon' at that point.

    8. Re:Missing in the Summary by mythosaz · · Score: 3, Funny

      I assume everyone I sleep with has HIV.

      That's why I don't have to tell them about mine.

    9. Re:Missing in the Summary by thebjorn · · Score: 2

      you don't remember correctly: http://en.wikipedia.org/wiki/C...

    10. Re:Missing in the Summary by niado · · Score: 4, Informative

      Although the work doesn't provide a definitive answer, it rules out one possible explanation

      ...that conditioning by itself likely cannot rid the body of the AIDS virus.

      No but a significant percentage of Europeans are resistant to HIV. Not sure what the news are here, Germans in general should have 25% chance of fighting off an HIV infection.

      You're a bit confused. Some Europeans (between 4% and 16%) carry a mutatation that reduces their likelihood of contracting specific HIV strains. The bone marrow donor mentioned in the summary had two copies of this mutated gene, which is a possible contributor to the "cure".

    11. Re:Missing in the Summary by rasmusbr · · Score: 2

      What about the non-HIV positive women they had sex with?

      Penis in anus sex has a much higher risk of transmitting HIV compared to penis in vagina sex. We're talking something like a factor of ten difference.

      It has always been a little bit mysterious that HIV manages to spread epidemically among heterosexual people who don't use iv drugs in Africa. I don't know if this mystery has been resolved yet.

  2. Simple. He's Immortal by Anonymous Coward · · Score: 5, Funny

    He can't die, you fool, unless his head comes away from his neck.

    now that he's outed, expect a seven-foot lunatic with a sword to come after him.

  3. Not a thorough analysis by pushing-robot · · Score: 5, Funny

    Does the subject possess any mysterious rings, amulets, or lamps?
    Does he make sacrifices to chthonic gods, and if so, which?
    Did he recently undertake a quest to bring together a collection of ancient magic gems?
    Is the hospital frequented by a wizard or a druid cult?

    I appreciate the work they did, but when they don't even consider the patient being swapped with his twin from an alternate dimension it's hard to call it rigorous.

    --
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    1. Re:Not a thorough analysis by rogoshen1 · · Score: 2

      it's never lupus.

    2. Re:Not a thorough analysis by BrennanPratt · · Score: 2

      They did check him for a triangular beard and oddly inverted morality, though.

  4. Summary missing punchline by quantaman · · Score: 5, Informative

    According to the summary

    Although the work doesn't provide a definitive answer, it rules out one possible explanation. [R]esearchers point to three different factors that could independently or in combination have rid Brown’s body of HIV.

    Unfortunately the summary forgets to mention the explanation that was ruled out or even clearly delineate the three different factors (though the latter was more the fault of the original article).

    From my reading of TFA:

    Explanation 1: Conditioning: The radiation that destroyed his immune system also killed off the HIV (because HIV lives in the cells of the immune system).

    Explanation 2: Shiny new immune system: The new bone marrow had a mutation that was immune to HIV and that cured him (maybe by detecting and killing HIV infected cells?).

    Explanation 3: Graft vs host: The new immune system killed off his old one, not just the HIV infected cells but all the old immune systems cells including those infected with HIV.

    So the researchers took chimps, extracted some stem cells (bone marrow?), infected them with SHIV (Simian HIV), destroyed their immune systems with radiation, then reinjected the uninfected stem cells.

    The SHIV quickly came back which rules out explanation 1.

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    1. Re:Summary missing punchline by Gavrielkay · · Score: 3, Informative

      The black death appears to still be considered a possibility for how the mutation got enriched in the population. Another possibility is smallpox. And according to what I've read, it's more like 15% European heritage have one copy of the CCR5-delta 32 mutation which provides limited resistance and 1% got two copies and have strong resistance but not complete immunity since some forms of the virus use other attachment points.

      citation: http://www.nature.com/scitable...

    2. Re:Summary missing punchline by teranine · · Score: 2

      The CD4 receptors on the surface of our T cells are used by HIV to gain entry into the cell. The concept is similar to a lock and key mechanism. A very small minority of people in the world (I thought it was less than 1% actually, not 10%), have a mutated CD4 receptor. So the key used by HIV to gain entry doesn't work, access to the cell's nucleus is blocked and replication of the virus does not occur.

    3. Re:Summary missing punchline by sjames · · Score: 3, Informative

      That's because they used SHIV, a hybrid virus, not SIV. They chose SHIV because it's response to anti-retrovirals resembles that of HIV.

  5. To any fundamentalists who may have stumbled in... by hyades1 · · Score: 2, Funny

    Looks like those curses from god just ain't what they used to be. :-)

    --
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  6. Re:To any fundamentalists who may have stumbled in by sinij · · Score: 3, Funny

    Please, try being a Pastafarian. I get cursed with a terminal disease at least once before my morning coffee. Considering our vengeful god, it is amazing any of us still alive.

    Partially due to above circumstances, on a long enough scale, Pastafarian mortality approaches 100%.