Researchers are celebrating what looks like a major step on the road to eventually finding a cure for the AIDS virus. At an international AIDS conference Wednesday, it was announced that following bone-marrow transplants for blood cancers, two HIV-infected patients in Boston are now virus-free and off their antiretroviral drugs. International AIDS Society president Françoise Barré-Sinoussi, who discovered the virus that causes AIDS, called the Boston findings “very interesting and very encouraging,” though at this point it means little for the 34 million around the world living with HIV but not blood cancer and without access to the best doctors or hospitals. The technique used on the two Boston patients is also extremely dangerous—it involves weakening the immune system ahead of the transplant—to the point that it’s ethical only if performed on someone already likely to die from cancer.
AIDS specialists are interested in the Boston patients because they offer new insights into how the immune system can be used to attack the virus.
Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said it was “conceivable and maybe even likely” that their H.I.V. was permanently gone.
If so, he said, it would show that it is not necessary to find a matching donor who had the delta-32 mutation.
Dr. Deeks, the AIDS researcher in California, said the cases raised the question of when to say an H.I.V. patient has been “cured.”
“Should we wait six months to see if the virus rebounds?” he asked. “Or will we have to wait up to five years, as oncologists tend to do with cancer?”
Dr. Barré-Sinoussi, of the International AIDS Society, said she might eventually prefer to adopt the term oncologists use: “in remission.”
The Boston patients' success echoes that of Timothy Ray Brown, the famous "Berlin patient," who after five years since receiving his bone-marrow transplant from a donor with a rare mutation conferring resistance to H.I.V. has show no signs of resurgent virus.
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