In Seattle, a little over 11 years ago, a young German doctor named Gero Hütter stood next to a poster he had come to share at an annual conference of doctors and researchers dedicated to treating HIV. Hütter, an oncologist, had little experience in the field of retroviruses, and few at the conference had any idea who he was. His poster was largely ignored. But that presentation, hung in the back of the conference and out of the spotlight, described one of the greatest medical breakthroughs of the decade: Hütter, while treating a patient for cancer, had cured the man's HIV.
On Tuesday, at the start of the same conference in Seattle—the 2019 Conference on Retroviruses and Opportunistic Infections—doctors announced that they had treated another patient who has now been HIV-free for over a year. This news was met with much more fanfare than Hütter's presentation in 2008: Headlines around the world proclaimed that HIV had been cured for a second time, in a second patient.
The scientists announcing the news were more cautious, calling it the second instance of "long-term remission," in which a person who once had HIV now seems to be free of the infection, even though he has not taken anti-HIV drugs for over a year.
The man, who has elected to remain anonymous, is identified as the "London patient." He joins Hütter's patient, the "Berlin patient," becoming the second person ever to enter long-term remission from HIV.
In 2007, Hütter's team preformed a bone-marrow transplant on a man fighting leukemia, who also had HIV. As the Berlin patient—Timothy Ray Brown—recovered from the punishing treatment (which essentially involved burning away his entire immune system to make room for new immune cells), doctors noticed something remarkable: Three months after the first transplant, as they performed tests, they could not find any trace of HIV.
Brown's extraordinary remission has been attributed, in general, to the fact that his donor bone-marrow cells had a mutation that makes certain immune cells resistant to HIV. (Germany had a registry of donors with the mutation, which is most common in people of Northern European descent.) As the transplanted marrow began rejuvenating Brown's immune system, immune cells that the HIV virus was unable to latch onto proliferated in his body.
However, Brown's recovery proved difficult to replicate, and, until this week, many in the medical community wondered if it might have been a fluke. There were specific circumstances peculiar to Brown's case: The cocktail of immunosuppressants doctors gave him after his transplant—a brutal version of transplant-treatment drugs that doctors no longer use—almost killed Brown. He was placed in an induced coma, but eventually recovered.
Some speculated that, for a bone-marrow transplant to help cure HIV, a patient would need to suffer the kind of near-death experience Brown survived. But the new case proves that such an experience isn't necessary. The London patient never came close to dying, and yet has been free of the virus for over year.
The London patient was treated for Hodgkin's lymphoma with a bone-marrow transplant in 2016. Doctors also treated him with immunosuppressants, but advances in transplant procedures and treatment meant that the drugs they used were more gentle than the ones doctors gave Brown over a decade ago. In September of 2017, with tests confirming he was free of the virus, the London patient stopped taking his anti-HIV drugs.
Brown, who is 52 and now lives in Palm Springs, California, celebrated the news. He told the New York Times, "I've been waiting for company for a long time."
The second-ever cure of a patient's HIV makes doctors hopeful that the infection could be eradicated in other patients. In 2017, 940,000 people died from HIV/AIDS-related illnesses worldwide. That was down from a peak of 1.9 million in 2004.