Dr. Awadhesh K. Gupta, medical director at Foley Walk-In Med Care, said he first heard of the medical breakthrough in April when he attended the Annual Conference of the American College of Physicians in Internal Medicine in Philadelphia.
It’s a conference Gupta tries to attend every year.
“This is the most prestigious organization of physicians in Internal Medicine and is responsible for certifying post graduate training in Internal Medicine. It is also one of the oldest,” he said.
According to Gupta, who has been practicing medicine in the South Baldwin area since 1997, the cure was first reported in early 2008 by a group of physicians from Germany at the annual conference on “Retroviruses and Opportunistic Infections” in Boston. The New England Journal of Medicine, one of the most prestigious medical journals in the world, finally published the report in its Feb. 12, 2009, issue, Gupta said.
So why has the news of the first case of HIV/AIDS cure received so little attention where the public is concerned?
“I can’t be sure as to why so little publicity,” Gupta said recently.
“My guess is that most scientific researchers are somewhat stunned that a clinician — not a research scientist — has been able to come up with the cure. Most of the big research money and big name American institutions are somewhat embarrassed to acknowledge that the very first case of HIV cure is not coming from their institutions.”
The cure, instead, is coming from Charity University Hospital in Berlin, Germany, and the doctor is Gero Huetter, who works in the Department of Hematology, Oncology and Transfusion Medicine at the same hospital.
Asked about the reaction of attendees at the medical conference in Philadelphia as regarded the news of an HIV/AIDS cure, Gupta said, “Unfortunately, because of the hectic schedule, I did not try to engage too many physicians. However, the doctor presenting this information seemed extremely excited about it.”
WORKING IN BERLIN
As Gupta explains the case and cure in question, a 40-year-old American working in Berlin had been HIV-positive for 10 years. The patient’s HIV infection had been under control for four years with “conventional HAART treatment regimen” (Highly Active Anti-Retroviral Therapy).
When the patient developed leukemia, however, a bone marrow transplant of stem cells was done using standard protocol, which Gupta said includes radiation therapy and chemotherapy prior to the transplant.
“Remember, once you stop HIV drugs, the HIV viral count rises very rapidly, usually within a few days to a week,” Gupta said.
According to Gupta, Huetter, the German physician treating the American, deliberately chose a stem cell donor who had a gene mutation known as “CCR-5 Delta- 32,” rather than using the best matched donor.
Gupta said Huetter remembered research first observed in 1996 - research Gupta said is well known in the scientific community. That research found that certain gay men in the San Francisco area remained uninfected with HIV in spite of engaging in risky sexual activities. As it was later discovered, those men had the CCR-5 Delta-32 gene mutation.
As it turned out, the patient’s stem cell transplant was a success, Gupta said, even though the patient had to have a second stem cell transplant (from the same donor) when his leukemia relapsed.
“This patient has been off all his HIV drugs for two years now,” Gupta said. “He continues to show no detectable signs of HIV in all the known places HIV is detected — no signs of HIV in his blood, bone marrow, lymph nodes, intestines or brain.” Also, the patient’s T-cell count remains normal.
Thus, according to Gupta, within the limits of scientists’ ability to detect HIV, it appears this patient’s HIV has been “eradicated.”
The gene mutation CCR-5 Delta-32 is found mostly in white European populations, especially northern Europeans and Scandanavians, according to Gupta, who is on the staff of South Baldwin Regional Medical Center and served as chief of medicine in 2008.
“Those who have this gene mutation from both parents are completely resistant to most common forms of HIV infection. You can get tested for it if you wish,” he said.
“It is believed that this genetic mutation may have happened during long periods of small pox, plague and other pandemics that devastated European populations.”
While the “American living in Berlin” case is in Gupta’s words the “first case of confirmed cure of HIV in the world,” he cites a 1989 case that is similar. Dr. John Rossi, currently at City of Hope Cancer Center in Durate, Calif., had a 41-year-old patient with AIDS and lymphoma. The patient underwent radiation and drug therapy in removing his bone marrow and receiving new cells from a donor.
Whether the donor had the CCR-5 Delta-32 gene mutation or not is not known, Gupta said, but when the patient died of his cancer at age 47 autopsy tests from eight organs and the tumor revealed no HIV.
“I have no doubts that present day high tech stem cell transplantation from CCR-5 Delta-32 donors can cure HIV,” Gupta said, noting, at the same time, that the procedure is expensive at present and has significant risks of complications and a high mortality related to the procedure itself.