The Ever-sharpening Spear Aimed at HIV

It's hard to keep track of the various strategies being employed to functionally cure HIV and their relative merits. A new book titled, Cured: How the Berlin Patients Defeated HIV and Forever Changed Medical Science by Nathalie Holt, does a great job at detailing these approaches and their histories.

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The book weaves together the paths of the two Berlin patients, Timothy Ray Brown and his predecessor Christian Hahn, who experienced functional cures of their HIV infections. While the story of Timothy Ray Brown is familiar to many in this field (receipt of a bone marrow transplant for leukemia from a donor who possessed the HIV resistance mutation CCR5Δ32), Christian Hahn's story is equally fascinating.

Hahn was placed on anti-HIV therapy soon after infection and his regimen included an unusual drug, hydroxyurea, with unique properties. After stopping therapy Hahn did not have any viral rebound. Debates over whether it was the timing of therapy, the use of hydroxyurea, or another factor ensued. In the end, Hahn was found to harbor a protective genetic signature HLA-B*57 that can control HIV replication.

The book also covers other cure approaches such as that employed with the Visconti Cohort, the "Mississippi Baby" (and her offspring, the "Long Beach Baby"), and the failed approach taken with the "Boston Patients" who underwent non-CCR5Δ32 bone marrow transplants. See this great amFAR graphic for a guided tour of these cure approaches. 

I highly recommend this book to those interested in getting a glimpse of the cutting-edge science being employed in this Herculean effort.