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July 1st, 2010
RFA-AI-10-009, HIV Cure, and “Berlin Patient” Update
Interesting “RFA” (Request for Application, #RFA-AI-10-009) from Bethesda:
The National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Mental Health (NIMH), National Institutes of Health (NIH), encourage grant applications from institutions/organizations to address the problem of HIV-1 persistence in HIV-1-infected persons treated with suppressive antiretroviral drug regimens… The goal of this initiative is to expand the knowledge base on HIV-1 latency and persistence so that eradication strategies can be designed, developed and evaluated.
In other words, research directed at a cure. If there’s any doubt about what the ultimate goal of the grant is, the title of the RFA is “Martin Delaney Collaboratory: Towards an HIV-1 Cure (U19)”, named in honor of the influential patient advocate who died last year.
I’ve written before about the “Berlin Patient” (here and here, for example) who, after receiving a bone marrow transplant from a donor homozygous for the delta-32 CCR5 mutation, was able to stop all antivirals without experiencing virologic rebound. The latest on him from the “cure” perspective is that even Bob Siliciano’s lab can’t find virus in the guy:
As of today, [the Berlin patient] remains healthy, and his HIV levels are undetectable … Even samples sent to Siliciano’s lab and other U.S. facilities that have the most sensitive assays have come up empty. Says Siliciano: “I think he’s cured.”
From single case report — one that began with an obscure research poster at the 2008 Retrovirus conference — to a complete cure of HIV, this case must be showing us the way to eradicate the virus.
And if you’d asked me ten years ago which I thought we’d see first, a truly effective HIV vaccine or a legitimate pathway to an HIV cure, I’d definitely had said the vaccine.
Now I’m not so sure …