Does HIV Cure Exist?

We may have seen phrases like “HIV cure” or “cure for HIV” in so many places that we might start to think that there is one. This disease has been infecting and killing people for more than 40 years, and unfortunately, we still don’t have a safe, effective, and widely available way to get rid of HIV from a person’s body completely.

Out of the 84 million people who are believed to have HIV infection, we do have an extremely small number of patients. What’s the good news here? These five HIV-infected patients seem to be entirely free of the virus and show no signs of it residing within their bodies.

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The “Berlin Patient”, Timothy Ray Brown

Timothy Ray Brown was diagnosed with HIV in 1995 before he was diagnosed with leukemia in 2006. His outlook had turned bleak. Gero Hütter, M.D., A German oncologist, conducted a never-been-done-before stem cell transplant procedure. The donor possessed a rare mutation called homozygous CCR5-delta 32, rendering him nearly immune to most types of HIV.

Even though the procedure was extremely risky to perform, it was successful. Following his transplant, Brown ceased his HIV antiretroviral medication. Despite this, subsequent thorough testing showed no evidence of an active, replicating, or dormant virus, indicating he remained free of HIV.

Unfortunately, Brown passed away in 2020 due to the return of his leukemia after years of remission.

The “London Patient”, Adam Castillejo

It was more than thirteen years after Timothy Ray Brown was cured of his infection that another similar case was found.

Adam Castillejo, a patient from London, faced a similar situation as Brown. He was diagnosed with HIV and Hodgkin lymphoma cancer that failed to respond to treatment. He underwent allogeneic hematopoietic stem cell transplantation after a stroke of transplant luck. He found a donor whose CD4 cells carried a rare mutation that rendered them resistant to most strains of HIV. This attempt was successful, marking only the second time in history that such an outcome was achieved.

After a year of the Major Research Conference in 2019, the experts in the field finally declared Castillejo’s case cured. It's widely understood that HIV is a challenging disease to eradicate from the body completely. At times, it may resurface months or years after undergoing treatment intended for a cure. It has made researchers very careful about whether to call a person “cured” of HIV or, instead, lean towards more accurate and simple phrases like “long-term remission.”

Adam Castillejo is now speaking about his life before and after being cured, playing a significant role in ending HIV stigma after taking a long period of staying silent as he did not want the possible fame of his newly found ‘cured’ status to take over him.

The “Düsseldorf Patient”

The procedure that cured Timothy Ray Brown is widely known as extremely risky among experts, but clinical researchers believe that it undeniably carries great potential for people infected with HIV. This is why this transplant procedure has been repeatedly performed in the 2010s.

The “Düsseldorf patient,"  a patient with acute myeloid leukaemia, is another rare case found to be “cured” of HIV after receiving a similar procedure Brown did in 2013. The donor possessed the extremely rare homozygous CCR5-delta 32 mutation, granting immunity against the majority of HIV strains.

A comprehensive research paper published in Nature Medicine outlined the absence of replicating HIV in the Düsseldorf patient four years post-cessation of antiretroviral therapy. The authors of the paper characterised his case as a "cure."

The “New York Patient”

The allopathic stem cell transplant procedure was one of the highest challenges in curing HIV between the 2000s and 2010s. It has dramatically led to the limitations of those who could benefit from it and explained why the number of successful cases is so small. Researchers are beginning to explore alternative approaches that are both safer and easier to replicate.

Researchers presented "The New York Patient" case at the annual Conference on Retroviruses and Opportunistic Infections in early 2022; like the cure cases before her, this patient had HIV and acute myeloid leukaemia. Unlike previous cases, she underwent a haplo-cord transplant, using umbilical cord blood from a partially matching donor with the CCR5-delta 32 mutation. Doctors increased the chances of success by transplanting peripheral blood mononuclear cells from a partially matched relative.

Based on the follow-up data published in the journal Cell in 2023, the New York patient is the first woman and the first person of mixed race to have been successfully cured of HIV after receiving the new cord blood stem cell transplant procedure, which causes extreme excitement among the experts because this procedure is more accessible compared to allogeneic stem cells and is considered somewhat safer. Experts believe that it has also cured her HIV and leukemia, raising hopes for its potential to achieve similar outcomes in numerous individuals facing similar challenges each year.

The “City of Hope Patient”, Paul Edmonds

Paul Edmonds has publicly disclosed his name since he was cured of HIV. As a man in his 60s and living in California, his older age makes his case more unique. He has been living with HIV the longest (diagnosed in 1988) before he received a stem cell transplant procedure at the age of 63 in 2019. Edmonds has remained cancer-free and has not experienced any HIV rebound, even after discontinuing antiretroviral therapy for more than a year. Edmonds also took a less intense chemotherapy regimen, which decreased the risk of complications without seeming to lower the chances of success.

These HIV “cure” cases have furthered our hope that the experts can continue to grow the number of people living with HIV for whom these transplant procedures can be viable.

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