AIDS Cure? Check.

This week, we found out that HIV has been cured.

For one patient.

For now.

Sort of.

The child was born to an untreated HIV-positive mother, which generally results in an HIV-positive baby. This child was given a more aggressive treatment than is common in this kind of circumstance, and which seems to have resulted in a cure. There are some nuances in the story that I am skipping over because:

1)      I am not a clinician

2)      I do not entirely understand them (see #1)

3)      I feel they are unimportant.

Oh, calm down, not that kind of unimportant. Clearly curing AIDS is important. All I mean is that the science and medicine behind this apparent breakthrough are not the most interesting part of this narrative. Instead, this event is the latest of some very unusual blips in the HIV/AIDS timeline that have taken place in the past six years.

Since the first published cases of AIDS in 1982, there have been fits and starts in the efforts to respond to the disease. Once HIV was isolated in 1984, the Centers for Disease Control and Prevention (CDC) predicted there would be a vaccine available by 1990, now overdue by 23 years. The first anti-retroviral drug for AIDS treatment, AZT, was approved in 1987 and was followed by many iterations of pharmaceutical interventions that have collectively treated patients and redefined HIV as a chronic disease rather than a rapid death sentence. [This information is sourced from this excellent timeline by POZ.]

However, starting with the Berlin Patient about six years ago, a new thread of the story of AIDS has emerged, one that finally seems to suggest that there is potential for something beyond prevention and disease management. (These two tools will remain the most effective options for some time, and prevention will always be the ideal.) The Berlin Patient, Timothy Brown, was given blood stem cell transplant treatment for leukemia from a donor who had a genetic mutation which is resistant to most strains of HIV. The resistance was transferred to Brown who is virus-free and has not needed HIV medications since 2007. Two patients in Boston had similar treatments last July, and have demonstrated positive results, and a number of unusual patients in France are reported to have “functional cures,” viral loads so low as to be almost undetectable. In a related development, a leukemia patient was successfully treated last year with a modified version of the virus that causes AIDS.

The impact on Baltimore of a true cure would be massive. The disease burden of HIV weighs more heavily here than many other places. Maryland, and Baltimore in particular, has among the highest rates of HIV in the country. Baltimore’s HIV prevalence rate is worse than that of all but the very hardest hit countries in the southern part of Africa.

Comparing statistics in a discrete urban area to an entire nation does not present an accurate picture, obviously. But, just in case you were thinking that this problem is a world away, know that it’s closer. More like a couple of yards.

The infant who has turned out to be disease-free this week is just the latest in a string of incidents that shows growth and promise in this seemingly intractable problem. This story is exciting, but it’s even more exciting to step back and take a look the accelerating changes in the epic tale of HIV/AIDS.