How Much Is Today's HIV Research Centered Around The Search For A Cure?

Mar 5, 2019
Originally published on March 5, 2019 7:24 pm
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MARY LOUISE KELLY, HOST:

Today a big announcement about HIV/AIDS - a second man's HIV infection is in remission. This is being hailed as a milestone in the search for a cure, which prompts a question. Decades into the epidemic with drugs available that prevent HIV infection and can treat it, how relevant is the search for a cure? We're going to put that question to Rowena Johnston. She is in Seattle for the conference where this news was announced today. She's the vice president and director of research for the Foundation for AIDS Research - amfAR. And she joined us from member station KUOW.

Rowena Johnston, welcome.

ROWENA JOHNSTON: Thank you very much.

KELLY: So I want to mention that your group amfAR funded the research, which is published today in the journal "Nature." Talk to me about this specific case and why it's a breakthrough. This has to do with a man with HIV and cancer who got a stem cell transplant.

JOHNSTON: That's right. We're referring to this man as the London patient. He was living in London and was living with HIV and developed cancer. And his cancer was not responding to normal treatments. And so he became a candidate for a stem cell transplant. And his physicians were really quite smart. And they decided to look for a donor who also had a CCR5-delta 32 mutation.

KELLY: OK.

JOHNSTON: And this mutation is quite rare, but people who have this mutation are highly resistant to HIV infection. And so by using cells from this donor, they were replacing the London patient's immune system with the immune system of a person who's highly resistant to HIV in a situation that was very closely similar to the Berlin patient, who we now do believe was cured.

KELLY: Between these two patients was - I believe it's a dozen years. And doctors had, of course, tried to replicate the results in those intervening years. And the virus kept coming back. Do we know why it was successful with this new patient, with this London patient?

JOHNSTON: You're right that there had been attempts to recapitulate what had happened in the Berlin patient. In some cases, the transplant recipients were getting donor cells from a person who did not have that CCR5-delta 32 genetic mutation. So it's beginning to look like having donors that have that mutation is a key element to this successful outcome. So it's really having the similarities and the differences between these cases and being able to compare them is where we're going to learn the valuable lessons to move us forward.

KELLY: Just to be clear, the London patient was dealing with a very specific health situation. In other words, the breakthrough that is being reported today does not mean that a widespread, universal cure is within immediate reach. Is that right?

JOHNSTON: That's right. Stem cell transplant is only appropriate for people who are living with a cancer of the immune system. So this intervention itself is not the way in which we are going to cure people living with HIV across the world. What this intervention is going to help us understand, though, is which are the critical components that we can learn from and put together so that we can develop some different type of cure that is appropriate everywhere that people are living with HIV.

KELLY: So let me circle you back to the question I posed at the outset, which is we - now decades into this grappling with HIV and AIDS, there are drugs which help prevent infection, which help people who are living with HIV infection manage it and live successful, long lives at this point. Why is it so important to find a cure?

JOHNSTON: A person living with HIV today needs to take their antiretroviral therapy every single day of their lives for the rest of their lives. And that becomes very burdensome both from an economic perspective and also, perhaps, from the perspective of their own health. And when you're taking antiretroviral therapy every day, you're reminded every day that you have this virus for which you are stigmatized.

And so having a cure for HIV relieves a lot of these burdens. And if we can cure this infection, that's going to encourage people to get tested for HIV because there's going to be that sense of optimism that they don't have to live with this virus for the rest of their lives.

KELLY: Rowena Johnston - she is research director for amfAR. That's the Foundation for AIDS Research. Thanks for your time.

JOHNSTON: Thank you very much. Transcript provided by NPR, Copyright NPR.