Just over a decade ago, researchers announced a first: They had cured a patient of HIV. Known as the Berlin patient, Timothy Ray Brown had needed a bone marrow transplant to treat his acute myeloid leukemia. Doctors used the opportunity to replace his bone marrow using stem cells from a donor with gene-based HIV immunity. It worked: Brown’s leukemia was cured, as was his HIV. More recently, in 2019, a second patient, this time being treated for Hodgkin’s lymphoma, was similarly cured in London.
But although these are the most famous stories where patients have been cured from HIV, their treatments represent just one option of many new approaches for tackling the virus — and one of the least widely applicable. It’s too invasive and too risky to conduct a bone marrow transplant on someone who doesn’t already have cancer that requires the procedure — especially considering most patients with an HIV diagnosis and access to care can effectively control the disease with drugs. In fact, a patient on antiretroviral therapy, or ART, today has the same life expectancy as a person without HIV.
Other new approaches show promise for more effectively treating, and yes, someday curing, HIV. This is especially important since not every patient responds well to ART — including those who suffer brutal side effects like bone loss and weight loss, as well as liver, kidney or heart problems. “[With ART], you’re putting an incredible amount of responsibility on the patient to ask them to take these drugs every day for the rest of their lives,” says Ryan McNamara, a virologist at the University of North Carolina at Chapel Hill.