Two pioneering physician-researchers at Brigham and Women’s Hospital have reported a groundbreaking development—two patients who received bone marrow transplants have no signs of the HIV virus, even after stopping anti-retroviral drugs.
Two Brigham and Women's Hospital patients with longstanding HIV infections who underwent bone marrow transplants have stopped anti-retroviral therapy and have no detectable HIV in their blood cells.
Daniel Kuritzkes, MD, and Timothy Henrich, MD (pictured above), physician-researchers in the Division of Infectious Diseases at Brigham and Women's Hospital, presented these findings on July 3, 2013, at the International AIDS Society Conference (IAS 2013) in Kuala Lumpur, Malaysia.
"While these results are exciting, they do not yet indicate that the men have been cured," said Henrich. "Long-term follow up of at least one year will be required to understand the full impact of a bone marrow transplant on HIV persistence."
In the summer of 2012, Henrich and Kuritzkes announced that the virus was easily detected in blood lymphocytes of both men prior to their transplants and became undetectable by eight months post-transplant. However, at the time, the men remained on anti-retroviral therapy.
Since coming off anti-retroviral therapy in spring of 2013, the men continue to have no detectable HIV DNA or RNA in their blood. The men are frequently monitored and researchers have expanded on their prior findings by further examining large volumes of cells, plasma, and tissue.
"We demonstrated at least a 1,000 to 10,000 fold reduction in the size of the HIV reservoir in the peripheral blood of these two patients, but the virus could still be present in other tissues such as the brain or gastrointestinal track," said Henrich. "If the virus does return, it would suggest that these other sites are an important reservoir of infectious virus and new approaches to measuring the reservoir at relevant sites will be needed to guide the development of HIV curative strategies."
The research of Henrich and Kuritzkes is supported by amfAR: The Foundation for AIDS Research, the National Institute of Allergy and Infectious Diseases, and the Bill and Melinda Gates Foundation.
Photo courtesy of the International AIDS Society/Steve Forrest.