I got an email this morning from Amfar alerting me to a case study published in February that I had missed. An American living in Germany has apparently been cured of HIV with a stem-cell transplant from a donor with the delta32 CCR5 mutation. This is more of a proof-of-concept than an actual course of therapy for most of us though. Stem-cell transplants are even harder to get than antiretrovirals for most of the world's HIV infected, and they aren't going to be rolling them out in Kwazulu-Natal any time soon. But from the proof of concept, maybe these geniuses can come up with something for the rest of the world.

In an attempt to cure the leukemia, he underwent a course of radiation therapy and chemotherapy in preparation for a stem cell transplant. But in his case, rather than simply using the best match among available stem cell donors, his physicians did something very clever. They also screened potential donors for a natural mutation known as delta32 CCR5. CCR5 is the primary means by which most types of HIV infect cells. Individuals lacking this CCR5 receptor—the 1.5 percent of the Caucasian population in America and Europe with the delta32 mutation—are completely resistant to infection by the most common forms of HIV.

The patient’s stem cell transplant was a success, although relapse of his leukemia required a second transplant using the same donor. Now off all anti-HIV drugs for almost two years, the patient continues to show no detectable signs of HIV in his blood, bone marrow, lymph nodes, intestines, or brain. To the limits of our ability to detect HIV, it appears that the virus has been eradicated from his body. At the very least this patient represents a functional cure: he is off all anti-HIV meds, has a normal T-cell count, and exhibits no evidence of virus.

amfAR, The Foundation for AIDS Research Research