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Timothy Brown, the Berlin Patient, Celebrates a Decade Cured of HIV

, by Liz Highleyman

BETA is reporting from the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle—bringing you the latest news, updates, and research on HIV treatment and prevention.

HIV advocates and researchers gathered in Seattle the day before the annual Conference on Retroviruses and Opportunistic Infections for a Community HIV Cure Research Workshop, held to inform community members of the latest advances in the field.

Timothy Ray Brown

Timothy Ray Brown (Photo: Liz Highleyman)

At the end of the meeting participants held a tenth “birthday” party for Timothy Ray Brown, formerly known as the Berlin Patient, celebrating 10 years since the bone marrow transplant that would lead to the only known cure for HIV.

Bone marrow transplant recipients at the Fred Hutchinson Cancer Research Center in Seattle, most of whom had cancer, have a tradition of celebrating “birthdays” on the date of their transplants that gave them a new lease on life.

In 2006, Brown was on antiretroviral therapy with good viral suppression when he developed leukemia and required bone marrow transplants after other treatment failed.

His doctor in Berlin, Gero Hütter, MD, had the idea to use bone marrow from a donor with a double CCR5-delta-32 mutation, meaning the stem cells were missing the CCR5 co-receptor that most types of HIV use to enter T-cells.

Brown underwent intensive chemotherapy that killed off his cancerous immune cells, nearly killing him in the process. The donor cells then rebuilt a new immune system that was resistant to most HIV.

“[Hütter] paid attention in medical school and said this could make you free of both leukemia and HIV and you’d never have to worry about it again at all, but I didn’t believe it,” Brown said at the party. “It was a hard survival, but I’m here.”

Although Brown stopped ART the day he received the first of two bone marrow transplants, his HIV did not return. Despite 10 years of poking and prodding—repeatedly testing his blood, immune cells, gut tissue, and everywhere else they could manage to look—researchers have not been able to detect replication-competent HIV anywhere in Brown’s body.

“Brown is why there is a cure research effort,” said Hans-Peter Kiem, MD, from Fred Hutchinson.

“In a way it seems like yesterday, but in a way it feels like a long time ago that I had to take medications every day,” Brown said. “That is the best part of my cure—not needing to take daily medication and not needing to depend constantly on my doctors for my survival.”

But Brown has recently started taking another type of daily pill. Since the donor’s stem cells were only missing the CCR5 receptor, Brown potentially remains susceptible to the minority of HIV strains that use a different receptor called CXCR4. For this reason, he revealed, he has started taking Truvada for pre-exposure prophylaxis.

“Recovery has taken too long, but I feel great and I am grateful for everything,” Brown said. “I still hang on to the hope that everyone living with HIV will be cured in my lifetime.”

Liz Highleyman is a freelance medical writer and editor of HIVandHepatitis.com.

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