Timothy Brown: The Berlin Patient
The Berlin Patient
For some reason, which remains entirely unclear to me, no one ever talks about the fact that a man has been cured of HIV. And, by cured, I mean that an individual used to have HIV, but no longer does. He has been completely free of the virus for six years, despite the fact that he is no longer on any medication for the disease.
Previously known simply as "The Berlin Patient," since late 2010, we now know that man as Tim Brown. Mr. Brown was diagnosed with the disease in 1995, just as anti-retroviral drugs were poised to arrive on the scene. With the help of a daily medication cocktail, he was able to manage his condition and live a normal life for nearly a dozen years until, after feeling extreme fatigue, which he chalked up to jet lag, he was diagnosed with leukemia in 2006. Doctors quickly began using the standard treatment: chemotherapy. Unfortunately, the chemo was unable to eradicate the cancer, and Brown was left with very few options.
What happened next could be the harbinger of a cure for the most perplexing disease of modern times.
The next, and only, step for Brown and his doctors was stem-cell replacement surgery. The primary physician attending Tim is an oncologist specializing in blood cancers named Gero Hutter, and he had a simple idea that seemingly no one else had ever considered.
There is a relatively small portion of the population (larger in Northern European regions) that is entirely resistant to the HIV virus based on a genetic mutation known as "Delta 32." For these individuals, the CCR5 receptors located on immune system cells, which serve as the channel through which HIV is introduced to the rest of the body, are disabled. If both parents of an offspring have this mutation, the child is basically entirely protected from the virus.
Hutter's idea, then, was to find a stem-cell donor that also had the Delta 32 mutation. In this way, he hoped to combat both Mr. Brown's leukemia and his HIV. After over 200 bone marrow donors had been declared matches, they tested them further for Delta 32. Of these, the 61st donor was identified as a total match. Amazingly, Hutter was the first physician to ever note the correlation between the mutation and a possible treatment option, and he was likewise the first to ever attempt the procedure.
Six Years Later
Brown claims that he has been off all anti-retroviral medication since the day prior to his surgery. He has also maintained that he has been HIV-negative for the entirety of the six years that have elapsed since his procedure. With cancer patients, a five-year absence of the disease is considered a "cure," so, by this metric, Tim Brown is the first human being to have ever been cured of HIV. Six years later, his liver, rectum, brain, and blood are constantly tested to ensure the absence of the disease, and, up until this past summer, there had never been a single instance of a positive test.
"Gero Hütter, Timothy Ray Brown, International Symposium HIV & Emerging Infectious Diseases"
Then, in June, doctors in California discovered a sample that contained trace elements of the virus. According to Steven Yukl, a scientist at the University of California, "There are some signals of the virus, and we don't know if they are real or contamination... at this point, we can't say for sure whether there's been complete eradication of HIV." However, Brown and Hutter refute these sentiments. Brown insists that he is HIV free, and Hutter has said that any traces of the virus are likely remnants of the disease that can neither replicate nor lead to a recurrence because the CCR5 receptors have been permanently disabled.
Tim Brown is an avid bicycle enthusiast, and he continues to ride to this day. He feels confident that both his cancer and HIV are mere relics of his past and is looking forward to a full life moving forward, but he also recognizes the miraculous nature of his new found physical health. And, implicit in that recognition, is a profound sense of gratitude and the desire to help others afflicted with this horrible disease. To that end, last year, Tim launched the Timothy Ray Brown Foundation, which is the first and only such organization ever exclusively dedicated to finding a cure for HIV.
"Timothy Ray Brown, the first person ever cured of HIV, is working with other patients seeking a cure."
As for this type of procedure being used as the model for future cures on a mass scale, many scientists don't feel that the outlook is nearly as bright as Brown's future or disposition. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases does believe that Brown has been officially cured, but he says that, while that's wonderful for him personally, it doesn't mean much for the advancement of cure research on the whole. Speaking with the New York Times, Fauci had the following to say: “It’s very nice, and it’s not even surprising, but it’s just off the table of practicality.” At this point, in order for massive amounts of people to be cured, there would have to be massive amounts of donors that have the relatively rare (1 in 100) Delta 32 genetic mutation.
Not only that, but Brown had had his immune system severely depleted by months of chemotherapy and radiation before the CCR5 inhibition, and many researchers think this may be an essential part of the process. Anyone that has ever been through this sort of ablation in the past will tell you that is an extremely difficult process that takes an immense physical and mental toll on a human being, making this part of crafting a cure based on genetics and immune system repression "off the table of practicality."
Live Through This
I can distinctly remember watching Magic Johnson's retirement press conference as a little kid. I'll never forget how my stomach dropped when I heard him announce those words. I was convinced, as most of us were, that one of my boyhood heroes would be dead within a few years. His diagnosis stuck with me throughout my childhood and into early adulthood. It changed the way that I viewed sex, sports, and mortality. Immediately, the man became a pariah, as close friends began openly questioning his sexuality in the media and the NBA basically forcing him into retirement.
"AP Photo/Mark J. Terrill David Stern was devastated when he learned Magic Johnson had been diagnosed with the HIV virus."
But Magic didn't die. With the help of anti-retroviral drugs, he's still very much alive today. His HIV is virtually undetectable, and he lives his life as casually as most multi-millionaires, I suppose. Johnson has been an inspiration to many, but his management of the disease has also led the general public to disregard the seriousness of the disease. Not everyone has the financial stability to afford the necessary medications, and those that don't, die - especially in Third World countries.
The case of Timothy Brown could be the first step in developing an actual cure for a disease that has baffled the world's greatest scientists for over thirty years. To achieve that, HIV research shouldn't be centered around management, it should be centered around eradication - total annihilation of this surreptitious virus. The goal shouldn't be merely living a manageable life, it should be living a healthy life free of regret with no limitations. We're only given one chance at this amazing adventure, and it shouldn't be compromised by bureaucrats arguing over funding, ignored by scholars squabbling over semantics, or silenced by critics intent on maintaining their fatalistic impulses.
McClellan, Liza. "'Berlin Patient' Timothy Brown Says He Is Still HIV-Free." Health. ABC News. 24 Jul. 2012. Web. 28 Feb. 2013.
Purdy, Dave. "The Cure for AIDS Rides a Bike." Commentary. Washington Blade. 13 Feb. 2013. Web. 27 Feb. 2013.
Rosenberg, Tina. "The Man Who Had AIDS and Now Does Not." News and Features. New York Magazine. 29 May 2011. Web. 28 Feb. 2013.
Salter, Jim. "Timothy Ray Brown, 'Berlin Patient,' And His Doctor Are Convinced HIV Cure Is Real." Healthy Living. Huffington Post. 9 Dec. 2012. Web. 28 Feb. 2013.