HIV progress offers hope in tragic week

In what has been a grim week for the international AIDS community, with the loss of former International AIDS Society president Joep Lange and Art Aids leader Jacqueline van Tongeren among the victims on Flight MH17 in Ukraine-reports have been confirmed on Monday that two HIV-positive men who were treated in Sydney now have "undetectable levels" of the virus.

The patients, who were treated at St Vincent's Hospital in partnership with the University of New South Wales' Kirby Institute, have undetectable levels of HIV more than three years after undergoing bone-marrow transplants. They were the first cases of HIV being successfully cleared in Australia.

The international AIDS community is mourning the deaths of researchers, activists, health workers and people with HIV after their plane crashed in Ukraine last week. They were traveling to Melbourne for a global AIDS conference.

David Cooper, director of the Kirby Institute at UNSW Australia, found some solace in the breakthrough, in the wake of the loss of his friend and colleague, Lange, with whom he worked for more than 30 years.

Cooper said Lange had "an absolute commitment to HIV treatment and care in Asia and Africa".

"Joep was absolutely committed to the development of affordable HIV treatments, particularly combination therapies, for use in resource-poor countries," Cooper said.

The breakthrough was to be heralded at a major gathering-Towards an HIV Cure Symposium-which was scheduled as part of the 20th International AIDS Conference in Melbourne. The gathering has instead became a focal point of grief for the community.

Despite the work being overshadowed for now by the plane crash, the long-term benefits of the Kirby Institute's research will be felt for years to come, Cooper said, as it herald's a new direction in research and new hope for HIV-positive people with leukemia and lymphoma.

In the Sydney cases, one patient had a successful bone marrow transplant in 2010 for non-Hodgkin's lymphoma. His donor had one of two possible copies of a gene that affords protection against the virus.

In 2011, a second man underwent a similar procedure for acute myeloid leukaemia, although his bone marrow donation had no genetic fingerprint affording protective immunity.

Both cleared the HIV virus but remain on anti-retroviral therapy as a protective measure.

"We're so pleased that both patients are doing reasonably well years after the treatment for their cancers and remain free of both the original cancer and the HIV virus," Cooper said.

Until now, the only person thought to have cleared HIV is an American man, Timothy Ray Brown, who had two bone marrow transplants in Berlin in 2007 and 2008.

In Boston, two other patients underwent similar transplants in 2012, but the transplanted cells did not contain the CCR5 gene mutation. In both cases the virus returned after anti-retroviral treatment was stopped.

(China Daily 07/22/2014 page11)