If AIDS has been cured, why is the victory party so small?


This week, Gizmodo and a handful of other media outlets published a story about a man who was reportedly cured of AIDS. But run a Google search for "AIDS cure" today, and what you get is a mixed bag—some articles about this specific case, some herbal medicine quackery, some older stories about other doctors hoping for their own AIDS breakthroughs, and even a New York Times piece from earlier this year about why we haven't found a cure for AIDS yet. If a miracle happened, why isn't it more obvious?

There's a couple of things going on here. Short answer: The case that's making headlines this week isn't new, and it comes with a whole bunch of caveats.

The cured man in question is Timothy Ray Brown, also known as "The Berlin Patient". Back in 2007, Brown had a serious relapse of acute myeloid leukemia. To treat him, doctors had to kill off Brown's blood cells with chemotherapy, and then replace them with healthy donor cells via a bone marrow transplant. That's just standard leukemia treatment. In Brown's case, though, the doctors decided to get a bit creative, and chose a bone marrow donor who possessed a rare genetic mutation that makes a very small percentage of humans resistant to HIV infection.

We've talked about AIDS non-progressors here before—people whose bodies just naturally fend off HIV. Despite exposure, they never end up with high viral loads and, thus, don't ever really get sick. In fact, some of them can keep HIV at bay so successfully that they appear to have no viral load at all. The person who donated bone marrow to Timothy Ray Brown had the genetic mutation that creates non-progressors. And, thanks to the donation, he or she seems to have passed that talent on to Brown.

The case was already well-known. In fact, the real media firestorm surrounding the Berlin Patient happened in 2008, when Brown's doctors published their first account of the apparent cure. The recent news is based on soon-to-be published follow-up that's basically saying, "Yup. Here we are, almost four years later, and it still looks like Brown is HIV free."

Of course, sometimes, it can look like a person is virus-free, but then, if they go off of their medications, the HIV can suddenly reappear. Part of why this new paper is significant is that is presents evidence that the mutated cells are replacing Brown's original cells in parts of the body where HIV is known to hide out—suggesting that, if he does have hidden virus reservoirs, they're taking a beating, too.

That's interesting, but there's really not a whole lot going on here that wasn't already reported in 2008—or in 2009, when an earlier follow-up was published. That's a big part of why you aren't seeing a veritable ticker-tape parade today.

The other reason for the reserved reaction: Brown's cure isn't especially transferable. Remember, he already had leukemia, so the chemotherapy and bone marrow transplant were, for him, a reasonable risk. But that's not true for everybody with AIDS. The chemo-and-transplant combo is actually something you're kind of lucky to survive, in and of itself. For people who are successfully managing HIV with anti-retroviral drugs, this is sort of like saying, "We have a way to prevent you from ever dying in a car accident. But first, we have to drop you off of the top of this three-story building." It's not really worth it.

Other researchers say it's not even clear that this avenue could lead to a safer method of curing AIDS patients, in which case, it's not so much a "cure" as an interesting bit of research.

What's more, this treatment is also incredibly expensive. Bear in mind, the majority of AIDS patients are poor people who live in Africa, far from the kind of medical infrastructure available to Brown in Europe. This isn't going to do much for them.

Bottom line, Timothy Ray Brown has been cured of AIDS—but AIDS hasn't been cured.

Thanks to RandomToon and Maiku81 for Submitterating!

Image courtesy Flickr user TimoStudios via CC


  1. “…chose a bone marrow donor who possessed a rare genetic mutation that makes a very small percentage of humans resistant to HIV infection.”

    Add to the list of problems. A very limited supply of bone marrow donors to with the needed resistance. Also, if the recent NASA announce taught us anything, it is that just because something is published, doesn’t mean it is going to pass peer review.

    1. it is that just because something is published, doesn’t mean it is going to pass peer review.

      Actually, I think what you’re trying to say is, “Just because something has passed peer review doesn’t mean it’s 100% problem-free and won’t be called into question later.”

      The arsenic paper was peer-reviewed. As have been all the papers published about the Berlin Patient.

  2. What niro5 said. Bone-marrow donation is an extremely painful and traumatic process. You can’t expect a handful of HIV-resistant donors to go through it more than once or twice.

    1. Yeah, AIDS is a symptom, not a disease.

      Ths hdln s ls vry msldng, s nyn wld knw frm rdng th rtcl.

      Btwn ths nd th ssng wrshp gng n ltly, ‘v lst tn f fth n Bngbng. Ths sd t b n ntllgnt blg. Nw t’s jst prrtng th mnstrm md wth lttl xtr cmmntry nd th ccsnl bt f “stmpnk” r vrprcd frntr.

      1. Oh, come on. I know what the headline means, you know what the headline means. I thought this was a great, really enjoyable and informative piece for BoingBoing to post. “losing faith” (whatever that means when it’s a blog, not something to put faith in) because the headline doesn’t match your exacting standards is a bit extreme.

        And besides, people have been wailing about “losing faith” due to misleading headlines and steampunk for years. It’s an old and tired complaint.

      2. You might want to review BoingBoing’s commenting policy:

        Please do not tell the Boing Boing editors what to blog. Writing “But that’s not a wonderful thing” is lame. So is “topic [X] bores me,” or “subject [Y] sucks.”

        Also I hardly think drawing attention to the railroading that the U.S. is subjecting a non-US citizen to is “parroting the mainstream media”. The worst part of the railroading is that the mainstream media tends to help with the process. BoingBoing doesn’t. If that offends you because you personally dislike Julian Assange, so be it.

      3. This used to be an intelligent blog.

        Then you started ‘contributing’, and people started disagreeing with you, because FYI you’re often rather disagreeable, off topic, and insulting.

      4. Don’t forget the occasional knee-jerk negativity towards alternative and natural medicine, thrown in whether well thought out or not.

        1. Sorry. Unproven claims of curing AIDS with useless homeopathy or (worse) actually dangerous would-be cures aren’t going to get respect from me just because somebody slaps the “natural” label on them. If it’s “knee-jerk negativity” to have issues with evidence-less snake oil peddled to the desperate, then fine. I’ll take the negativity.

      5. 1) It would be correct to say that “AIDS has been cured,” if it were, not “HIV has been cured.” HIV is a virus. You don’t cure viruses, unless they themselves are sick. You cure diseases. AIDS is a disease. If you don’t think AIDS is a disease, take it up with the CDC.

        2) The headline was not misleading. It was explaining that the reason there is no victory parade is that AIDS has not been cured. It’s equivalent top saying “if there’s technologically-advanced life on Mars, why aren’t they sending us messages?” The statement answers itself.

        3) The mainstream media’s position is a very nuanced, clear explanation of what the Berlin Patient means for the future of AIDS cure and research? Surprise to me. I guess the mainstream media has gotten better these days.

  3. Maggie, thanks for simply clarifying the peer-review -> publish process. It’s important to know this so we understand what we’re getting when we read published content.

  4. The procedure sounds like a “cure” for AIDS the same way a heart transplant is a “cure” for heart disease. How about we have the “hooray AIDs has gone the way of smallpox” party when they figure out a less “nuclear option” way of curing it? You know, like an immunization shot or a pill.

  5. We have a way to prevent you from ever dying in a car accident. But first, we have to drop you off of the top of this three-story building.

    I would personally think that it is worth it. The most obvious (and probably the rationalization for the rest) would be to see if the results are repeatable. “In the interest of science,” as it were.

    There is a psychological element to this in that there is a stigma to HIV/AIDS such that I think some people would endure anything that could potentially beat the disease in a meaningful way as apposed to keeping it at bay. It’s the difference between the slogan “I am not dying of HIV/AIDS, I am living with it” and something like “I beat HIV/AIDS.” The prohibitive expense of all these procedures is another matter altogether and probably the stopping point for most people in the world. It sadly makes me think of the South Park episode where Magic Johnson revealed that he cured his HIV by just treating it with money. Tons and tons of straight cash.

    1. If it were a choice I think most people would take it but even getting a donor match is hard, adding a rare genetic variant to that—it will never even be an option for most. I’m sure the extremely rich will find a way but even then finding a match would be exceedingly difficult.

  6. Thanks for posting on this, Maggie. I was wondering about the small noise level, and know I know why.

  7. Thanks for blogging on this. Seriously, my facebook blew up with “They’ve cured AIDS/HIV!” earlier this week, and it took every fiber of my being not to tell people that it was somewhat old news and that this has only been applied to one person so far.

  8. AIDs hasn’t been cured. AIDs has been cured in one particular man of a unique genetic makeup, for whom there happened to be a matching donor handy. This is a non-story. It irritated me when I read the headline the other day, but I suppose I have only myself to blame, as I should know better by now.

    On that note, I’ll believe this gentleman has been cured when he is 5+ years out and still has a healthy CD4 count, no viral count and is free of opportunistic infections.

    1. AIDs hasn’t been cured. AIDs has been cured in one particular man of a unique genetic makeup, for whom there happened to be a matching donor handy. This is a non-story.

      This is pretty much exactly what I said in the post. Not sure what the problem is, then.

  9. Maggie, as with most other transplants, do bone marrow recipients need to take anti-rejection drugs, and if so wouldn’t this normally be a very bad thing for those infected with HIV? TIA

  10. I just wanted to say that adding Maggie to the semi-permanent BB staff is the best thing to happen to the site in a long time. I love what she brings to the table. You don’t need to moderate/approve my comment, because it doesn’t really add to the conversation here, but please do make sure Maggie knows she has fans who really appreciate her articles.

  11. This sub-population was bred during the bubonic plague. You have to do a few things. One you can bet that until these folks’s bone marrow can be grown in a lab, they’ll be paid very very well by the infected rich. 2 There is a multibillion HIV treatment industry out there. It will not die easy. 3 There is a multibillion HIV charity industry out there, it will not die easy. The anti-embryonic stem-cell community might get a whole new set of allies soon.

  12. This result is more significant than people are making it sound because it opens the door to the possibility that people could be cured by taking their own bone marrow stem cells, using gene therapy to insert an siRNA construct that knocks down CCR5 expression, then re-introducing the cells to the body. Obviously, this wouldn’t exactly mimic the situation of this leukemia patient, but it’s possible that it might work.

    @hassenpfeffer: They don’t have to harvest bone marrow stem cells by drilling into the bone any more. They have drugs that will cause the stem cells to mobilize into peripheral blood, then they can be harvested from a vein just like a normal blood donation.

  13. not worth it? i’m not certain about that.

    i’m an idealist (sue me), but as a person living with HIV, the idea of, say, volunteering to help further this avenue of research is very appealing. i’m not certain how one goes about these things, but i’m thinking, “not worth it?” i say it is. sure, the odds of survival are marginal, and not everyone of us is built the same, but this sounds to me like a case where the world ought to take further action. even this isn’t a cure for AIDS/HIV, this ought to be reported louder, frankly. what does the lay world know about AIDS/HIV anyway? seems as if there was more imformation readily available to the public twenty years ago.

    i’m thinking, say, i were to undergo all the treatments mr brown did (for obv different reasons) and i died, but the resulting data revealed that this was a “one-time fluke” and nothing further could be learned, or that there were further signs for a new sort of treatment, i’d say the people who would benefit from this death, either way, would say that it is worth it. because my life is worth it, i think.

  14. I’ve had a transplant – very similiar to this for Acute Lymphoblastic Leukemia. I figure having some actual experience in this area, I might as well contribute. I’d like to point out that in addition to chemotherapy, you’re forgetting about the total body irradiation usually necessary. Those parts are the actual hazards.

    Well and any other preparation before – it shouldn’t surprise anybody that insurance companies would want to have a full array of tests before they commit big bucks to going forward with a bone marrow transplant.

    After that the actual transplant part isn’t really much to worry about – at least for me it was about the same as a blood transfusion except instead of blood it consists almost entirely of stem cells.

    I did have to take anti-rejection medications like Rapamycin and Tacrolimus for about 2 years afterwards. Some people have to take immune suppressants for less time, some for far longer – it really depends on how well the new immune system settles with your body.

    As a final related note – a procedure such as this one will turn the survivor into a chimera, since all of your blood will have a different set of DNA than the rest of your body.

  15. This is very similar to the cure to Multiple Sclerosis that was recently successful.

    In that case they use stem cells from your own body to make new bone marrow – and then wipe out your entire immune system. Then they replace your bone marrow cells with your newly created ones.

    That way your immune system has basically been rebooted. It is effectively a cure for almost all autoimmune diseases because you we now have the power to force a person’s entire immune system to reboot from scratch – so it will forget all the bad mistakes it has learned.

    Like the AIDS ‘cure’ it has a very high chance of killing you if it doesn’t succeed.

    The odd thing about the MS cure was how little fanfare there has been … nobody has been daring to use the ‘c’ word despite what an unbelievably massive breakthrough it is.

  16. Nice summary of the history of the “Berlin patient.” The reason this is so exciting is not because you would subject people to chemotherapy to cure them of AIDS, but it suggests a new treatment approach where you modify the patient’s t-cells to give them the “genetic mutation that creates non-progressors.”

    Here’s a New York Time article that describes the “zinc fingers” technique that could be used:


    The story mentions a company in the Bay Area, Sangamo Biosciences, that’s already got two clinical trials going:


    A patient enrolled in one of the trials recently said his t-cell count has doubled:


    Lots more info here:


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