By
Jeffrey Laurence, M.D.
At a research
meeting in Boston In March 2008, German physician Dr. Gero Hütter presented an
abstract describing the probable cure of a patient with both HIV and leukemia
through a special type of stem cell transplant.
To discuss and debate these intriguing findings, a few months later
amfAR convened a meeting of a dozen scientists, including Dr. Hütter.
Arrangements were made to have blood samples sent from the “Berlin patient”—now
known to be Timothy Ray Brown, an American living in Germany—to labs throughout
the U.S. to verify Dr. Hütter’s conclusions. This initiated a series of amfAR
convened meetings, or think tanks, to move the cure agenda forward.
amfAR organized
one such meeting in September 2011 to discuss avenues to more practical methods
of engineering an AIDS cure that would avoid the marked side effects, expense,
and difficulty in finding an appropriate stem cell donor, associated with the protocol
that cured Timothy Brown. Held at Villanova
University on the outskirts of Philadelphia, this think tank generated discussion
about ways to genetically engineer a patient’s own stem cells to become HIV
resistant.
In June 2012,
amfAR convened a different group—scientists and clinicians involved with
approaches to an AIDS cure in children—to discuss potential ways to take advantage
of the special nature of the immune system in the very young.
Most recently,
in September 2012, amfAR convened two back-to-back think tanks in Amsterdam with
European scientists. One focused on the role of the immune system and immune-based
therapies as adjuncts to anti-HIV drugs in attempts to eradicate HIV. The other
led to the formation of a group of participating physicians and scientists committed
to establishing a standard protocol for performing stem cell and bone marrow
transplants in HIV-infected individuals who need them for reasons other than
curing AIDS, usually leukemia or lymphoma.
Currently such
guidelines don’t exist, either in the U.S. or Europe. This effort would also
enable collection of data on a person’s immune status and viral load, which
should help scientists define exactly what it was about Timothy Brown’s
treatment—the use of a special CCR5-negative donor, the preparative
chemotherapy, the radiation, the immune suppressants, or all of these
conditions—that was necessary to cure him.
Dr. Laurence is amfAR’s senior
scientific consultant.