HIV can conceal itself from our immune system, making it virtually impossible to treat. There has only been one reported cure, of Timothy Ray Brown, commonly known as the Berlin patient. His cure is unconventional and unviable. Until now.

Recently, an international team of scientists have discovered a specialised group of cytotoxic T cells (TC cells), expressing the chemokine receptor CXCR5, that can enter the B cell follicles, and then eradicate TFH cells, which is where HIV enters and hides from the immune system during treatment of patients with antiretroviral drugs. Stopping of such treatment would result in the reservoirs of HIV cells becoming active again.

The specialised group of TC cells are produced by our immune system naturally, but not abundantly enough to rid the patient of HIV. The challenge that now that lies ahead is to ramp up the production of such cells to counter HIV.

Viable cure for HIV

Currently HIV patients no other viable option other than to be on a lifelong regime on antiretroviral drugs. Such a discovery has huge potential to treat many other infections, of which also include the Epstein–Barr virus (human herpes virus 4).

An estimated 36.7 million people live with HIV/AIDS worldwide. In Singapore, according to the latest update by the Ministry of Health, there are a total of 5,324 patients living with HIV.

“We could potentially transfer these specialised super potent killer T cells into patients, or we could treat patients with proteins that can drag these specialised killer T cells into the right spots, specifically to the hot spots where HIV can hide during antiviral treatment,” says Professor Sharon Lewin, a co-author of the study.

Berlin Patient’s Cure

Such a discovery would also enable scientists to craft a viable cure for HIV, as the method used to cure the Berlin Patient would be too gruelling for most patients. The headline-making patient was cured with a three step process that was able to rid him of the virus.

The first is conditioning, in which doctors destroyed Brown’s own immune system with chemotherapy and whole body irradiation to prepare him for his bone marrow transplant.

Thereafter, oncologist Gero Hütter took an additional step that he hypothesised might not only cure the leukaemia but also help rid Brown’s body of HIV - he found a bone marrow donor which possessed a rare mutation in a gene that cripples how HIV hides itself. He was right.

The third part of the process involved utilising his new immune system to attack the remnants of his old one that held HIV-infected cells, a process known as graft versus host disease.

Thus, there is an urgent need for additional research into a viable cure for this devastating virus. While there is hope that this current research will lead to expedited progress for the benefit of HIV sufferers worldwide, for now preventative safety measures during sexual activity is crucial to avoid transmission of HIV. MIMS

Singapore Ministry of Health update on the HIV/AIDS Situation in Singapore 2015 (June 2016)