As a medical student back in the 1990's I quickly learnt that a diagnosis of HIV infection was likely to prove fatal. The few drugs that were available had unpleasant side effects and did little to improve chances of survival. Fast forward more than 20 years and HIV infection can be controlled and deaths from AIDS in the UK are rare. In a recent case study published in Lancet HIV it's clear that researchers have gone one step further and announced findings that represent hope for a potential cure.
Adam Castillejo was diagnosed with HIV at the age of 23. A bone marrow transplant to treat an unrelated condition in 2015 led to a cure. An interview with Adam can be found here.
Adam Castillejo, who until recently was only known as the "London Patient", has been found to be free of infection more than 17 years after testing positive for HIV. The patient's recovery has been attributed to a bone marrow transplant that he received during treatment for an unrelated Hodgkin Lymphoma. Fortunately, Adam was able to receive stem cells that contained a delta 32 mutation that provided his immune system with protection from HIV. Now 30 months after stopping treatment, the signs are that he is free from infection.
'Ignorance=Fear" by Keith Haring
According to the US Department of Health and Human Services, in 2018 37.9 million people world wide had HIV. 80% knew their diagnosis and 60% had access to antiretroviral treatment. In the same year, deaths from HIV-related diseases numbered 770,000.
Whilst the risks of undertaking a bone marrow transplant make this treatment unsuitable for most of those with HIV infection, these findings represent a real step towards finding a cure for the disease. In the future it may be possible to target the patient's own genes and manipulate stem cells in order to resist HIV. Meanwhile, ongoing efforts to reduce transmission and increase availability of antiretroviral drugs must continue if we have any chance of controlling this most devastating of diseases.