Timothy Ray Brown

Timothy Ray Brown (born 1966) is an American considered to be the first person cured of HIV/AIDS.[1][2] Brown was called "The Berlin Patient" at the 2008 Conference on Retroviruses and Opportunistic Infections, where his cure was first announced, in order to preserve his anonymity. He chose to come forward in 2010. “I didn’t want to be the only person cured,” he said. “I wanted to do what I could to make [a cure] possible. My first step was releasing my name and image to the public.”[3][1][4]

Eleven years later, nearly on the same date, at the same conference, it was announced that it appeared that a second man had been cured. He was called "The London Patient", who later identified himself as Adam Castillejo.[5] He also received a bone marrow transplant to treat a cancer (Hodgkin's lymphoma) but was given weaker immunosuppressive drugs. The selected donor also carried the CCR5-Δ32 mutation.[6][7]

Procedure

Brown was diagnosed with HIV in 1995 while studying in Berlin, Germany.[3] In 2006, he was diagnosed with acute myeloid leukemia. On February 7, 2007 he underwent a procedure known as hematopoietic stem cell transplantation to treat leukemia[8] (performed by a team of doctors in Berlin, Germany, including Gero Hütter). From 60 matching donors, they selected a [CCR5]-Δ32 homozygous donor, an individual with two genetic copies of a rare variant of a cell surface receptor. This genetic trait confers resistance to HIV infection by blocking attachment of HIV to the cell. Roughly 10% of people of European or Western Asian ancestry have this inherited mutation, but it is rarer in other populations.[9][10] The transplant was repeated a year later after a leukemia relapse. Over the three years after the initial transplant, and despite discontinuing antiretroviral therapy, researchers could not detect HIV in Brown's blood or in various biopsies.[11] Levels of HIV-specific antibodies in Timothy Brown's blood also declined, suggesting that functional HIV may have been eliminated from his body. However, scientists studying his case warn that this remission of HIV infection is unusual.[12]

Brown, the "Berlin patient", suffered from graft-versus-host disease and leukoencephalopathy – both transplant complications that are potentially fatal. This means that the procedure should not be performed on others with HIV, even if sufficient numbers of suitable donors could be found.[13][14]

As of 2017, six more people also appear to have been cleared of HIV after getting graft-versus-host disease; only one of them had received CCR5 mutant stem cells, so it appears that when a transplant recipient has graft-versus-host disease the transplanted cells may kill off the host's HIV-infected immune cells.[15]

Timothy Ray Brown Foundation

In July 2012, Brown announced the formation of the Timothy Ray Brown Foundation in Washington, DC, a foundation dedicated to fighting HIV/AIDS.[16][17]

See also

References
  1. Mary Engel (February 20, 2019). "Timothy Ray Brown: The accidental AIDS icon". Fred Hutch. Retrieved March 4, 2015.
  2. Trudy Ring (2012-09-07). "Is Anyone Immune to HIV?". HIVPlusMag. Retrieved 2015-01-20.
  3. Timothy Ray Brown (January 12, 2015). "I am the Berlin patient: a personal reflection". AIDS Research and Human Retroviruses. 31 (1): 2–3. doi:10.1089/aid.2014.0224. PMC 4287108. PMID 25328084.
  4. https://www.dropbox.com/s/hi5juvoexk9lfwh/berlin%20patient.pdf?dl=0
  5. Davis, Nicola (9 March 2020). "Second person ever to be cleared of HIV reveals identity". The Guardian.
  6. Apoorva Mandavilli (March 4, 2019). "H.I.V. Is Reported Cured in a Second Patient, a Milestone in the Global AIDS Epidemic". The New York Times. Retrieved March 4, 2019.
  7. https://www.dropbox.com/s/hi5juvoexk9lfwh/berlin%20patient.pdf?dl=0
  8. "German HIV patient cured after stem cell transplant". Belfast Telegraph. 15 December 2010. Retrieved 15 December 2010.
  9. "Bone marrow 'cures HIV patient'". BBC News. 13 November 2008. Retrieved 2009-01-02.
  10. Novembre, J; Galvani, AP; Slatkin, M (2005). "The Geographic Spread of the CCR5 Δ32 HIV-Resistance Allele". PLoS Biology. 3 (11): e339. doi:10.1371/journal.pbio.0030339. PMC 1255740. PMID 16216086.
  11. Allers, K.; Hutter, G.; Hofmann, J.; Loddenkemper, C.; Rieger, K.; Thiel, E.; Schneider, T. (2010). "Evidence for the cure of HIV infection by CCR5 32/ 32 stem cell transplantation". Blood. 117 (10): 2791–2799. doi:10.1182/blood-2010-09-309591. PMID 21148083.
  12. http://www.aidsmeds.com/articles/hiv_aids_stemcell_2042_14199.shtml
  13. Levy JA (2009). "Not an HIV Cure, but Encouraging New Directions". N Engl J Med. 360 (7): 724–725. doi:10.1056/NEJMe0810248. PMID 19213687. Retrieved 2009-03-31.
  14. Lunzen, J.; Fehse, B.; Hauber, J. (2011). "Gene Therapy Strategies: Can We Eradicate HIV?". Current HIV/AIDS Reports. 8 (2): 78–84. doi:10.1007/s11904-011-0073-9. PMID 21331536.
  15. Clare Wilson (May 6, 2017). "Immune war with donor cells after transplant may wipe out HIV". New Scientist.
  16. "Man "cured" of AIDS: Timothy Ray Brown". CBSNews. Retrieved 2015-01-20.
  17. https://www.the-scientist.com/notebook/miraculous-activist-35553
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